• Stephen C Porter, Patrick Johnston, Gareth Parry, Fran Damian, Eric C Hoppa, and Anne M Stack.
• Division of Emergency Medicine, Children's Hospital Boston, MA, USA. stephen.porter@sickkids.ca
• Pediatr Emerg Care. 2011 Feb 1;27(2):75-80.

ObjectiveWe implemented and evaluated a quality improvement initiative targeting parents' communication with clinicians in a pediatric emergency department (ED).MethodsA quality improvement initiative ("Clear and Concise Communication" or "3C") targeting parent-provider communication was implemented in an urban tertiary care pediatric ED. A 1-page form that solicited parent worries, questions, and expectations for care was developed. Parent-provider communication was measured using an 8-item subset of questions from an ongoing satisfaction survey adopted for pediatric emergency care. The primary outcome was the communication score for a given ED visit scaled from 0 to 100 and was calculated as the simple average of answers where the best possible response was given a value of 1 and all others were scored as 0. A multivariate model adjusting for time-related factors, ED volume, and system-level events was developed to examine the influence of the communication initiative.ResultsA total of 29,005 patients received care during implementation of 3C; a total of 100,810 patients received care during the 2-year period of interest. Data from 1233 satisfaction surveys were used to create the communication scores. Communication scores ranged from 0 to 100, with a mean of 88 and SD of 17.7. In a linear model adjusting for day, weekend, volume, system-level introduction of electronic charting for nurses, and electronic-order entry for physicians, the 3C initiative demonstrated a positive and statistically significant effect-increasing the communication score by 2.8 points/100 d (95% confidence interval, 0.1-5.5).ConclusionsThe 3C initiative succeeded in improving parents' communication experience with emergency providers during the intervention period.

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