08 Improving caregiver experiences during critically ill children’s transfer: A participatory action research initiative
Bibliographic record
Abstract
Abstract Background The transfer of critically ill children from community hospitals to tertiary care centers is a challenging process that often results in heightened caregiver stress, commonly referred to as "relocation stress." At British Columbia Children’s Hospital (BCCH), over 300 paediatric patients are transferred annually to the Pediatric Intensive Care Unit (PICU), yet no standardized support process exists to address caregiver needs during these transitions. Objectives This project aimed to improve caregivers’ transfer experience by developing a comprehensive, web-based support tool using Participatory Action Research (PAR). Design/Methods A four-phase PAR framework guided this quality improvement initiative (Figure 1). Phase 1 involved a literature review and a caregiver survey to identify caregiver needs during transfer. During Phase 2, an alpha prototype website was developed with content tailored for transfers to BCCH and Victoria General Hospital (VGH). During Phase 3 key partners were invited to review the website through virtual sessions and provide feedback through semi-structured interviews. The feedback underwent thematic analysis to identify areas for refinement. Phase 4 focused on refining the website into a finalized version, integrating partner recommendations. Results In Phase 1, the literature review identified key caregiver needs, including clear information about the transfer process and a desire to accompany their child during transport. 32 caregivers (22 mothers, 7 fathers, 3 others) completed the survey and revealed additional needs such as practical information on hospital preparation (10/32), food availability (9/32), and expectations for the child’s arrival at the PICU (8/32). In Phase 2, an alpha prototype of the web resource was created on the platform Notion. During Phase 3, partner feedback was gathered from 16 participants: 6 parent partners, 5 nurses, 3 Indigenous Health Liaisons, and 2 social workers. Thematic analysis identified 42 codes grouped into eight themes, including clarity, emotional support, and cultural sensitivity (Table 1). In Phase 4, the website was refined with enhanced visuals, clearer navigation, and expanded culturally sensitive content. The finalized version has been integrated into the Child Health BC website. Conclusion This project underscores the critical need to address caregiver needs during PICU transfers. Using PAR, we developed and refined a sustainable, accessible website to support families. The resource will evolve through ongoing data collection, including website metrics and email feedback, with future updates focused on enhancing content, usability, and accessibility based on caregiver and stakeholder input.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.067 | 0.040 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.013 | 0.009 |
| Scholarly communication | 0.006 | 0.003 |
| Open science | 0.004 | 0.014 |
| Research integrity | 0.002 | 0.005 |
| 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".