257 Clinician and Parent Perceptions on a System for Real-Time Feedback of Patient Reported Outcomes in Children with Burn Injuries

Abstract

Introduction: The Burn Outcomes Questionnaire (BOQ) for children ages 5-18 is a validated parent-reported outcome survey that assesses children's recovery from burn injuries on twelve psychosocial and physical domains. A feedback system, which allowed for real-time delivery of BOQ and Pediatric Symptom Checklist-17 (BOQ+P) results to clinicians prior to a patient's encounter, was implemented in an outpatient burn clinic and an outpatient burn surgery unit. This study aimed to assess clinicians' and parents' perceived usefulness of the system. Method(s): The BOQ+P was administered on iPads to parents of children with a burn injury involving >=5% of the total body surface area (TBSA) or a critical area (face, hands, feet, genitalia). Scores were normed using previously collected data from a cohort of over 1000 pediatric burn patients. The scored report presented subscale scores in green, yellow, or red if the patients were performing above, within, or below average, respectively. The summary of results was presented to clinicians before the patient's clinic appointment or after the outpatient surgery. Clinician and parent perceptions and usefulness of the BOQ+P feedback system were assessed with Likert scale questions after the encounter. Result(s): Between the two study sites, 193 feedback encounters were conducted. Approximately half of the clinicians (51.8%) agreed and 2.1% disagreed that the BOQ+P data was helpful. The remaining 46.1% of clinicians neither agreed nor disagreed its usefulness. Additionally, 46.7% of the surveyed clinicians reported that the BOQ+P data stimulated a conversation with the patient or a family member, and 38% of clinicians found that the information had an impact on interventions that they recommended during the encounter. Of the 145 parents who completed a debriefing questionnaire, a large majority (94.8%) reported that the survey results brought up concerns important to their children. Furthermore, 90.4% would like to see the iPad in future visits and 99.3% would recommend the feedback system to another parent of a child with a burn injury. Conclusion(s): About half of the participating clinicians reported that they perceived the feedback system to be useful and to have stimulated discussion with the patient's family. Fewer found that the feedback system impacted their recommended interventions. The collection and real-time delivery of patient-reported outcome measures is viewed favorably by most parents of pediatric burn patients. Applicability of Research to Practice: While surveyed parents rate the feedback system positively and would like to continue using it in future clinic visits, our results suggest a need to identify elements of the feedback system that are most useful to clinicians prior to implementation into routine care.