Introduction: Children with medical complexity (CMC) comprise a growing share of pediatric hospitalizations, particularly in pediatric intensive care units, where they account for over half of annual admissions. Their intricate medical needs place them at significantly higher risk for adverse events, with error rates estimated to be five times greater than in children without complex chronic conditions. Despite this, no widely adopted or standardized tool exists that consolidates essential medical information in a format that is easily accessible to all providers involved in their care. This study seeks to define the core components of a portable medical passport for CMC to reduce medical errors and improve patient safety. Methods: A multidisciplinary needs assessment including both providers and caregivers was conducted via an online survey. Participants were asked to identify the most critical information to be included in a medical passport and to provide insights on strategies for its upkeep and maintenance. Data were analyzed using descriptive statistics. Results: A total of 98 participants completed the survey, comprising 7% caregivers, 19% physicians, 36% registered nurses, 18% respiratory therapists, and 20% advanced practice providers, therapists, and other support staff. Applying a 70% consensus threshold, both caregivers and healthcare professionals aligned on the vast majority of information deemed essential for inclusion in the medical passport. Key elements identified included a comprehensive problem list, ventilator settings, and detailed tube feeding regimens. Similarly, there was strong agreement on which categories to omit such as prior culture results and vaccine history. Notably, differences emerged around elements such as patient values and family-specific requests, which caregivers prioritized more highly. The most commonly anticipated barriers to implementation were the challenges of maintaining the document’s accuracy over time and where the document should be housed. Conclusions: This needs assessment engaged key stakeholders in identifying the critical elements for a passport. We intend to use this data to serve as a base for the development and implementation of a document to enhance patient safety and reduce medical errors across all care settings for this vulnerable population.
Finney et al. (Sun,) studied this question.