Children with medical complexity in the emergency department: Parent experiences and information needs
Bibliographic record
Abstract
• Children with medical complexity (CMC) have a unique experience accessing emergency department (ED) care. • Parents of CMC are key care coordinators that cooperate with their child’s care team and pediatrician to mitigate ED visits. • Parents of CMC identify challenges in communicating their child’s extensive health history in ED settings. • Emergency Information Forms (EIFs) are an underutilized tool to share info between parents and health care providers. Children with complex medical needs constitute a growing number of pediatric patients that utilize the emergency department, disproportionately more than children outside of this category. Our objective for this qualitative study was to explore information needs and experiences of parents accessing emergency health care for their child with medical complexity. Qualitative description guided this study. Parent participants were recruited via purposive sampling and individually interviewed within a pediatric specialty clinic at a Canadian pediatric tertiary care center. Inductive content analysis organized interview data from parents. Nine, 60–90 min individual interviews were conducted with parents of a child with medical complexity; four content categories emerged: How the emergency department is different for children with medical complexity, parents as key care coordinators, emergency department experience and resilience, and communication and learning preferences. These families openly shared their experience with pediatric emergency care. Strategies to support transfer of pertinent health information for children with complex medical needs are needed in the emergency department. Interviews with parents of children with complex medical needs provided key insights to inform and improve the care provided in the emergency department for this growing population of children.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.003 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".