A Trial to Improve Family Clinical Note Access and Outcomes for Hospitalized Children

NCT ID: NCT06722378

Last Updated: 2025-12-18

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

630 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-04-01

Study Completion Date

2029-04-30

Brief Summary

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This study will test if giving parents access to their child's medical notes on a bedside tablet:

* helps them get more involved in their care
* helps identify safety concerns

Parents of hospitalized children will be randomly assigned to either use the Bedside Notes tool or follow usual care.

To see if this approach improves care and safety, researchers will measure:

* note access
* parent-reported safety concerns
* overall experiences

Detailed Description

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Hospitalized children face alarming rates of harm due to medical errors, yet parents often lack access to the clinical information necessary to partner effectively in their child's care. Although clinicians are required to share inpatient clinical notes detailing diagnoses and treatment plans, \<10% of parents access these notes during hospitalization. To address this critical gap, we developed the Bedside Notes intervention, a multicomponent strategy to improve parent access to clinical notes during their child's hospitalization and engage them in safety efforts. The intervention includes: (1) real-time access to inpatient notes through their child's patient portal on a bedside tablet and (2) a notes orientation video. In a single-center study, this intervention was associated with a \>10-fold increase in parent note access and enabled 20% of parents to identify potential safety concerns, with 60% of these concerns confirmed as safety issues.

This multisite randomized controlled trial (RCT) will evaluate the effectiveness of the Bedside Notes intervention in improving parent access to inpatient notes and enhancing safety reporting. Specific aims are to: (1) assess the impact of the intervention on parent note access, (2) evaluate its effect on parent-reported safety concerns and experiences, and (3) identify barriers and facilitators to implementation. Guided by the Systems Engineering Initiative for Patient Safety 2.0 framework, this hybrid type 1 RCT will enroll English- and Spanish-speaking parents of 600 children admitted to pediatric services at three hospitals. Parents will be randomized to either: (1) usual care (access to outpatient portals on personal devices) or (2) the Bedside Notes intervention (proxy access to patient portal on bedside tablets with accompanying orientation video). A subset of parents and healthcare staff will also be interviewed about their experience with the intervention. Data will be collected through surveys, interviews, and electronic health record audits.

This study is the first multisite RCT to evaluate the impact of inpatient note access on parent-reported outcomes. By leveraging bilingual recruitment, two EHR platforms, and input from a national advisory group, the study addresses barriers to equitable access and sustainability. Findings will advance understanding of how health information technology can engage parents as partners in improving inpatient safety for children and inform broader efforts to integrate families into safety initiatives.

Conditions

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Hospitalized Child Pediatric Patient Safety Medical Errors Parental Engagement in Care Inpatient Pediatric Care

Keywords

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Family-Centered Care Electronic Health Records (EHR) Safety Reporting Parent Note Access Quality Improvement

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Access to notes on a tablet

Participants will be provided a tablet and will be able to access their child's medical notes while in the hospital.

Group Type EXPERIMENTAL

Access to medical notes

Intervention Type OTHER

Inpatient notes shared in real-time on a hospital-owned bedside tablet linked to their child's records.

Care as usual

Participants will not have access to a table to view their child's medical notes while in the hospital.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Access to medical notes

Inpatient notes shared in real-time on a hospital-owned bedside tablet linked to their child's records.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* English and Spanish-speaking parents or guardians of children under 12 years old who were hospitalized on a general pediatric service at one of the 3 centers
* Age 18 and over

Exclusion Criteria

* Parents of children 12 years of age and older
* Parents unable to give written informed consent
* Parents of children admitted for suspected abuse or neglect
* Anticipated discharge within 24 hours
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Agency for Healthcare Research and Quality (AHRQ)

FED

Sponsor Role collaborator

Pediatric Research in Inpatient Settings (PRIS) Network

UNKNOWN

Sponsor Role collaborator

University of Wisconsin, Madison

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Michelle Kelly, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Madison

Locations

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Children's Hospital of Los Angeles

Los Angeles, California, United States

Site Status RECRUITING

Seattle Children's Hospital

Seattle, Washington, United States

Site Status NOT_YET_RECRUITING

American Family Children's Hospital

Madison, Wisconsin, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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Michelle Kelly, MD, PhD

Role: CONTACT

Phone: (608) 265-5545

Email: [email protected]

Amanda Gatewood

Role: CONTACT

Email: [email protected]

References

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O'Hare C, Gatewood AK, Baird J, Brown R, Coller RJ, Desai A, Egan A, Gerber D, McGuire T, Singh-Verdeflor KD, Smith CA, Verdelis GA, Warner G, Wong S, Kelly MM. A multicenter randomized trial to improve family clinical note access and outcomes for hospitalized children: The Bedside Notes study protocol. J Hosp Med. 2025 Nov;20(11):1256-1264. doi: 10.1002/jhm.70155. Epub 2025 Aug 21.

Reference Type BACKGROUND
PMID: 40839550 (View on PubMed)

Other Identifiers

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1R01HS030098-01

Identifier Type: AHRQ

Identifier Source: secondary_id

View Link

Protocol Version 2/6/2025

Identifier Type: OTHER

Identifier Source: secondary_id

A536771

Identifier Type: OTHER

Identifier Source: secondary_id

2024-1396

Identifier Type: -

Identifier Source: org_study_id