Pilot testing a Trauma-Informed Clinician Communication Intervention for Family-Centered Rounds

When admitted to the hospital, Black and Latino children are at greater risk of medical errors, surgical complications, longer, more-costly hospital stays, and mortality. Although many factors play a role, poor clinician communication likely contributes to these disparities in health outcomes. Across settings, including our preliminary work in the inpatient pediatric environment, Black and Latino patients have been shown to experience worse communication quality, particularly in domains of trauma-informed practice such as collaboration and empowerment. Despite robust evidence that differences in communication exist and influence health outcomes, few have developed and tested communication interventions grounded in a praxis trauma-informed care. To meet this evidence gap we will test the feasibility, acceptability, and preliminary efficacy of a trauma-informed communication intervention that teaches clinicians communication skills aligned with principles such as collaboration, empowerment, and trustworthiness. To do this, we will co-develop and refine a clinician coaching communication intervention with iterative feedback from Black and Latino caregivers as well as clinicians of children in the hospital. We will then randomize 10 clinicians to an intervention or waitlist group; clinicians in the intervention group will receive the intervention immediately, while clinicians in the waitlist group will initially serve as the control arm then receive the intervention to provide feasibility and acceptability data. We will assess the feasibility of recruiting and collecting data as well as acceptability of the intervention by clinicians. We will explore preliminary efficacy for the effect of the intervention on clinician-caregiver communication quality. We hypothesize that our intervention will improve clinician communication quality through increasing behaviors of partnership, affirmation, support, respect, and interpreter best practice, which will lead to greater caregiver participation during family-centered rounds. We will explore the effect of the intervention on caregiver empowerment, adverse events, length of stay, and child 7 and 30 day unplanned readmission. The new knowledge generated from the proposed research will guide our research team in designing and conducting an NIH R01 clinical trial of the intervention to enhance the standard of care for children admitted to the hospital.