The most reliable and valid approach to measure whether parents' informational needs are being met is to ask parents directly. Chart reviews to monitor whether key topics were discussed and parents had their needs met are not valid sources for this information, as providers often do not document what they discuss and it is difficult for them to know whether parents had all of their questions answered. By involving parents in the measurement process, you will ensure that your efforts are parent-centered and that you are getting feedback from the people for whom you are trying to improve care.
One way to determine whether parents are having their informational needs met on specific anticipatory guidance and parental education topics is to administer the Promoting Healthy Development Survey (PHDS) in your practice. The PHDS, developed by the Child and Adolescent Health Measurement Initiative, is a standardized, validated, parent-based survey that has age-specific components. It enables practices to ensure that their improvement efforts are relevant and valuable to parents of children of different ages.
This survey asks parents whether key recommended topics were discussed and whether they had their informational needs met either through these discussions or through other sources of information such as handouts, posters, or other materials. By using this survey, you can focus on developing communication tools and handouts on the topics about which parents in your own practice indicated they would like more information or discussion.
Overall, PHDS results have shown that parents are likely to have their informational needs met on topics related to physical care and injury prevention. They are likely to have unmet informational needs on topics related to development and behavior. Parents were most likely to report they would like more information and guidance from their child's health care providers about:
- night waking and fussing
- bed and naptime routines
- issues related to communication—what child is able to understand
- toilet training
- guidance and discipline techniques
National and Regional Findings from the PHDS
Recent studies using the PHDS highlight topics for which parents are most likely to have unmet informational needs. This information can be valuable in guiding quality improvement efforts if you do not have the resources to implement the PHDS in your office. However, it is best to gather data in your own practice so that you can get feedback from your own patients.
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