Comparing children's and parents' perspectives on hospital care

Feedback from patients is essential in order to achieve patient centred care.  In the paediatric environment, the need to hear directly from children has been identified since the 1990’s, but we are still struggling to hear children’s voices in relation to their medical care.  There is currently very little published information available about children’s views of the care that they receive during hospital admission.  Parent’s opinions on the hospital staff and environment may not necessarily reflect those of their children.  Gaining a better understanding of children’s perspectives, will allow service improvements to be more closely tailored towards patient’s needs. We are currently conducting an improvement project in the paediatric inpatient ward of The Royal Free Hospital.  Our aim is to investigate whether differences exist between children’s and parents’ perspectives of the hospital staff and environment, and to identify children’s priorities. We used the expertise of both clinical staff and inpatient school teachers to develop two questionnaires for children aged 6-11years and 12-18years.  A questionnaire addressing similar topics was developed for parents in order to provide a direct comparison.  The questions asked patients and parents to rate their experiences of the hospital staff and environment and asked open questions on how services could be improved.  Parents were directed to simultaneously complete a parental questionnaire, whilst encouraging children to complete their own questionnaire as independently as possible.  Parental and patient questionnaires were reviewed anonymously. Preliminary results confirmed that children’s views are not always mirrored by their parents.  Traditionally, obtaining feedback from children regarding their hospital experiences has been poor.  This project highlights the need to develop methods of obtaining more direct feedback from children and the need to introduce a culture of routinely seeking children’s perspectives in order to improve patient centred care.