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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
MCHbest. Medical Home: Family Centered Care.

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Strategy. Communication and Information Sharing

Approach. Train healthcare professionals to improve their communication skills to enhance family-centered care

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Overview. There are multiple frameworks designed to improve communication between healthcare professionals and the families in their care.[1, 2, 3, 4] Some shared themes include language translation, team culture, importance of empathy, and improved understanding and integration of the family experience into care decision making.[1, 2, 3, 4, 5] Improving healthcare professionals' communication skills and confidence, and focusing on family-centered care, results in better alignment with the needs and preferences of patients and their families.[1, 3, 5]

Evidence. Moderate Evidence. Strategies with this rating are likely to work. These strategies have been tested more than once and results trend positive overall; however, further research is needed to confirm effects, especially with multiple population groups. These strategies also trend positive in combination with other strategies. (Clarifying Note: The WWFH database calls this "some evidence").

Access the peer-reviewed evidence through the MCH Digital Library or related evidence source. (Read more about understanding evidence ratings).

Source. Peer-Reviewed Literature

Outcome Components. This strategy has shown to have impact on the following outcomes (Read more about these categories):

  • Patient Experience of Care. This study improves individuals' perceptions, feelings, and satisfaction with the healthcare services they receive.
  • Provider Experience of Care. This strategy improves healthcare professionals' perceptions, feelings, and satisfaction with the work environment and systems they use.
  • Quality of Care. This strategy promotes the degree to which healthcare services meet established standards aimed at achieving optimal health outcomes.

Detailed Outcomes. For specific outcomes related to each study supporting this strategy, access the peer-reviewed evidence and read the Intervention Results for each study.

Intervention Type. Collaboration (Read more about intervention types and levels as defined by the Public Health Intervention Wheel).

Intervention Level. Community-Focused

Examples from the Field. There are currently no ESMs that use this strategy. As Title V agencies begin to incorporate this strategy into ESMs, examples will be available here. Until then, you can search for ESMs that have similar intervention components in the ESM database.

Sample ESMs. Here are sample ESMs to use as models for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies).

Quadrant 1:
Measuring Quantity of Effort ("What/how much did we do?")

PROCESS MEASURES:

  • Number of healthcare professionals participating in communication skills training for family-centered care. (Measures workforce engagement in training)
  • Number of communication training modules developed for healthcare professionals. (Assesses availability of training resources)

OUTCOME MEASURES:

  • Number of healthcare professionals demonstrating improved communication skills after training. (Measures impact of training on individual competencies)
  • Number of patient interactions where trained communication skills are effectively used. (Assesses application of skills in practice)

Quadrant 2:
Measuring Quality of Effort ("How well did we do it?")

PROCESS MEASURES:

  • Percent of communication training programs incorporating experiential learning methods. (Measures use of effective adult learning strategies)
  • Percent of healthcare professionals receiving ongoing coaching in communication skills. (Assesses post-training support for skills application)

OUTCOME MEASURES:

  • Percent of patients reporting feeling heard and involved in their care due to effective provider communication. (Measures patient-reported outcomes related to communication)
  • Percent of patient encounters where key information is clearly communicated and documented. (Assesses impact of skills on information-sharing)

Quadrant 3:
Measuring Quantity of Effect ("Is anyone better off?")

PROCESS MEASURES:

  • Number of communication training programs developed in collaboration with patient and family partners. (Measures co-design of training with key partners)
  • Number of policies established to prioritize communication skills development in healthcare. (Shows system-level support for communication training)

OUTCOME MEASURES:

  • Number of healthcare programs integrating evidence-based communication skills curricula. (Measures upstream impact on workforce preparation)
  • Number of research studies contributing to the evidence base on communication skills training effectiveness. (Shows knowledge generation to advance the field)

Quadrant 4:
Measuring Quality of Effect ("How are they better off?")

PROCESS MEASURES:

  • Percent of communication training programs prioritizing needs of diverse patient populations. (Measures focus on equity in training design)
  • Percent of training content reinforcing principles of cultural humility and trauma-informed care. (Assesses integration of equity principles in training)

OUTCOME MEASURES:

  • Percent reduction in communication barriers experienced by patients from diverse backgrounds. (Measures impact of training on reducing communication inequities)
  • Percent of patients from various communities reporting feeling respected and understood in healthcare interactions. (Assesses experience of inclusivity in communication)

Note. When looking at your ESMs, SPMs, or other strategies:

  1. Move from measuring quantity to quality.
  2. Move from measuring effort to effect.
  3. Quadrant 1 strategies should be used sparingly, when no other data exists.
  4. The most effective measurement combines strategies in all levels, with most in Quadrants 2 and 4.

Learn More. Read how to create stronger ESMs and how to measure ESM impact more meaningfully through Results-Based Accountability.

References

[1] Riley M, Patterson V, Lane JC, Won KM, Ranalli L. The Adolescent Champion Model: Primary Care Becomes Adolescent-Centered via Targeted Quality Improvement. J Pediatr. 2018 Feb;193:229-236.e1. doi: 10.1016/j.jpeds.2017.09.084. Epub 2017 Nov 29. PMID: 29198766

[2] Mackie BR et al., Application of the READY framework supports effective communication between health care providers and family members in intensive care, Australian Critical Care, https://doi.org/10.1016/j.aucc.2020.07.010

[3] The ALIGN Framework A Parent-Informed Approach to Prognostic Communication for Infants With Neurologic Conditions Monica E. Lemmon, Mary C. Barks, Simran Bansal, Sarah Bernstein, Erica C. Kaye, Hannah C. Glass, Peter A. Ubel, Debra Brandon, Kathryn I. Pollak Neurology Feb 2023, 100 (8) e800-e807; DOI: 10.1212/WNL.0000000000201600

[4] Adams S, Nicholas D, Mahant S, Weiser N, Kanani R, Boydell K, Cohen E. Care maps and care plans for children with medical complexity. Child Care Health Dev. 2019 Jan;45(1):104-110. doi: 10.1111/cch.12632. PMID: 30462842.

[5] Franck LS, Axelin A, Van Veenendaal NR, Bacchini F. Improving Neonatal Intensive Care Unit Quality and Safety with Family-Centered Care. Clin Perinatol. 2023 Jun;50(2):449-472. doi: 10.1016/j.clp.2023.01.007. Epub 2023 Mar 21. PMID: 37201991.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.