629 - Family Experience of Care and Distress Following Injury: Comparing the Standard of Care to a Virtual Pediatric Trauma Center Model of Care

Monday, May 1, 2023

9:30 AM – 11:30 AM ET

Poster Number: 629
Publication Number: 629.455

James Marcin, UC Davis Health, Sacramento, CA, United States; Daniel J. Tancredi, University of California, Davis, School of Medicine, Sacramento, CA, United States; Joseph M. Galante, University of California, Davis, School of Medicine, Sacramento, CA, United States; Kendra Grether-Jones, University of California, Davis, School of Medicine, Sacramento, CA, United States; Michelle Y. Hamline, University of California Davis, Sacramento, California, CA, United States; Brian M. Haus, University of California Davis Children's Hospital, Sacramento, CA, United States; Holly Leshikar, Uc davis children’s hospital, Sacramento, CA, United States; Tanya Rinderknecht, University of California, Davis, School of Medicine, Sacramento, CA, United States; Jennifer Rosenthal, University of California Davis Children's Hospital, Sacramento, CA, United States; Marike Zwienenberg, University of California Davis Children's Hospital, Sacramento, CA, United States; Jeffrey S. Hoch, UC Davis, Sacramento, CA, United States; Katherine Rominger, UCDH, Sacramento, CA, United States; April Sanders, University of California, Davis, School of Medicine, Sacramento, CA, United States; Jolene L. Lavine, University of California Davis Children's Hospital, Sacramento, CA, United States; Raynald Dizon, University of California, Davis, School of Medicine, Sacramento, CA, United States; Nathan Kuppermann, UC Davis School of Medicine, Sacrametno, CA, United States

Presenting Author(s)

James Marcin, MD, MPH (they/them/theirs)

Professor
UC Davis Health
Sacramento, California, United States

Background: The “Virtual Pediatric Trauma Center” (VPTC) is a model of care that uses telemedicine and image sharing when conducting pediatric trauma consultations for acutely injured children from a regional level I pediatric trauma center to an Emergency Department (ED) in a non-pediatric trauma center hospital. The VPTC model of care could improve family experience of care and reduce distress based upon the telemedicine connection. We are conducting a PCORI-funded trial to compare family experience of care and family distress following childhood injury using the VPTC model of care compared to the current standard of care (telephone consultations).

Objective: The objective of this study is to compare the 3-day experience of care and distress experienced by family members participating in the two models of care being tested: the VPTC model and the current standard of care.

Design/Methods:

This is a randomized trial enrolling children younger than 18 years old with physical trauma presenting to any of 10 hospitals in northern California, including Level II, Level III, and non-designated trauma centers. Over two years, we are conducting a stepped wedge design trial, starting with the standard of care (telephone consultation with the trauma team), switching to the VPTC model of care (telemedicine and image sharing with the trauma team). To measure family experience of care and distress 3-days post injury, we used the CAHPS Child Hospital survey and the State-Trait Anxiety Inventory Form Y survey. Mean differences were calculated accounting for hospitals as fixed-effects.

Results: 595 injured children (369 assigned to VPTC; 226 assigned to standard of care) were eligible for the study. 56% of those assigned to VPTC received the assigned intervention. The mean within-hospital difference in CAHPS scores between the VPTC model and standard of care was -0.02 (95% CI: -0.19, 0.15). The mean within-hospital difference in the State-Trait Anxiety Inventory scores between the VPTC model and standard of care was 0.07 (95% CI: -0.08, 0.23).

Conclusion(s): Families of acutely injured children presenting to community and rural EDs rated their experience of care and distress similarly whether or not they received telemedicine consultations in a VPTC model of care. Further planned analyses are being conducted using secondary aims to investigate whether or not the VPTC model of care has an impact on family experience of care and distress following childhood injury.