Tailoring Communication for Families: Enhancing Understanding and Reducing Stress in Pediatric Care

By Emily Revelle

Communication is the basis of all things we do in healthcare. When done well, it allows us to present vital information to the family, work well together as a medical team, and establish psychological safety. When done poorly, it will do the opposite and can increase mistrust of the medical system. What is unique to the pediatric experience is that when we are sharing information, we are not only educating the patient, but the patient AND their family.

High level information coming from leadership does well to educate staff and providers but can often be too wordy and detail-heavy for use with families. The Family Partner Program at St. Louis Children’s Hospital creates family-friendly teaching tools that effectively communicate information while being mindful of literacy levels, design, and scope of information.

We have partnered with hospital leadership to create tools on non-clinical topics, such as double bunking, sibling visitation, unit access, viral season visiting plans, as well as hospital-specific changes. (Our clinical partners also utilize our PFAC to provide feedback on clinically based teaching tools). Once created, these tools are utilized throughout the hospital and translated into the top five languages we see in our patient population. Clear communication is so critical to the success, or failure, of how the message will be received.

We take a massive amount of information that went into making the decision (the science, logistics, and policies) and look at it through the family lens, taking only the most critical pieces of information to create the teaching tool. Our team values trauma informed care and understands the compounded trauma of having a sick child in the hospital. For example, communication about visitor changes in a pediatric intensive care unit must be tailored to the family and simple to digest in a stressful moment. The average literacy level for our families is about 8^th grade, but when you compound that with the stress, fatigue, and hunger that many families are experiencing with a child in the hospital, the average comprehension level drops to about 3^rd grade. This is why we experience significant gaps in the families’ understanding of a hospital policy. We need clear and effective communication to prevent family frustration and confusion. Families can then focus on taking care of themselves and their child.

The tools created by the Family Partner Program aim to:

• Communicate care plan changes clearly and in plain language
• Explain to families what to expect and when to expect it
• Tell families who to contact if they have questions

For example, when we begin to see our census increase, leaders may anticipate that double bunking also needs to increase. While sharing a room is never ideal, it is especially problematic within the pediatric population for many reasons, such as differing ages of roommates, infection precautions, privacy, and the number of visitors at the bedside. By addressing these concerns directly and clearly, we hope to ease the anxiety that can come from misinformation or lack of understanding. We hope to anticipate the concerns and questions of families and then address them in our teaching tools. The unit leaders then take the tools and post them in the appropriate family-facing areas and pass them out during leader rounding.

Family communication tools are effective ways to share information equitably with all families but will never replace a quality face-to-face conversation. While the need to share information is not in itself unique to pediatrics, valuable family teaching tools can be a critical piece of the communication plan when tackling topics that impact the experience of your patients and families.

Emily Revelle
As a former NICU mom of 24-week twin boys, Emily Revelle is a Lead Family Partner at St. Louis Children’s Hospital. She joined the Family Partner Program as a volunteer in 2018 and has been on staff since 2019. Family Partners work to center the voice of all families and teach and promote Patient and Family Centered Care throughout the hospital.