• Patricia Peña Jiménez, Wendy Leatherman Phipps, Elizabeth Jacob-Files, Elizabeth Lindo, Lauren C Rakes, Joan S Roberts, Jonna D Clark, Emily R Berkman, and Katie R Nielsen.
• Department of Pediatrics, Critical Care Medicine, Driscoll Children's Hospital, Corpus Christi, TX.
• Pediatr Crit Care Me. 2024 Dec 1; 25 (12): 115911671159-1167.

ObjectivesTo improve continuity of care, some PICUs assign a continuity attending (CA) physician for children with prolonged hospitalizations. Little is known about how this intervention impacts familial caregivers' experiences. The objective of this study was to provide in-depth descriptions of family perspectives about continuity of care during prolonged PICU hospitalizations for children with and without a PICU CA.DesignQualitative semi-structured interviews.SettingSingle center cohort, from October 2021 to December 2022, at an academic PICU in the United States.ParticipantsFamilial caregivers (n = 39) of critically ill children hospitalized in the PICU for greater than or equal to 14 days were purposively sampled, stratified by group: 18 with a PICU CA and 21 without a PICU CA.InterventionsNone.Measurements And Main ResultsSemi-structured interviews were audio recorded, transcribed, coded, and analyzed in the context of the continuity of care model using a realist thematic approach. Familial caregivers described six themes related to relational, informational, and management continuity: 1) familiar providers who demonstrate empathy for the child improve family members' comfort and trust (Relational); 2) providers who know and use a child's baseline health status to inform clinical decision-making alleviate family members' stress (Relational, Management); 3) information loss during care team transitions frustrates families (Informational, Management); 4) known providers enhance caregiver communication (Informational); 5) familiar providers who value a family's expertise about their child's care (Relational, Management); and 6) take responsibility for the child's long-term care plan (Management) decrease parental stress.ConclusionsAs PICU patient medical complexity and length of stay increase, familial caregivers' needs transition from understanding day-to-day management to navigating care team transitions and partnering with providers to develop long-term care plans. Targeted interventions to increase provider continuity that consider relational, informational, and management continuity are needed to optimize patient outcomes and family experiences.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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