PediHome: Development of a Family-Reported Measure of Pediatric Home Healthcare Quality

Carolyn Foster*, Aaron J. Kaat, Sara Shaunfield, Elaine Lin, Cara Coleman, Margaret Storey, Luis Morales, Matthew M. Davis

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective: No validated tools exist to measure pediatric home healthcare quality. The objective of this work was to develop a family-reported survey (PediHome) to measure the quality of home healthcare for children with medical complexity (CMC). Methods: A national multidisciplinary expert panel (N = 19) was convened to develop survey content domains. Panelist were joined by 3 additional experts to rank candidate survey items for importance and evaluate relevance and structure. Cognitive interviews were conducted with English-speaking (n = 12) and Spanish-speaking (n = 4) family caregivers of CMC to revise problematic items and clarify response options. A cross-sectional survey was then fielded (6/1/20–10/31/20) to parents whose children receive healthcare at 2 regional academic medical centers. Results: The final measure included N = 28 total items with 4 items quantifying access, 1 evaluating overall quality rating, and 21 items assessing provider tasks (11 home nursing only, 2 certified nursing assistant/home health aide only, and 1 dual). Out of 312 caregivers of CMC, 142 (46%) responded and one-half (n = 68, 48%) reported a child receiving home nursing. They received a weekly median of 58.4% (IQR ±31.2%) of approved nursing hours with 55% reporting a missed nursing shift within the last month. Median overall quality was 75-9 (0–10 scale) and median scores on specific quality items ranged from 31-4 to 43-4 (0–4 scale). Conclusions: PediHome is a new content-valid family-reported measure of home healthcare quality for CMC that is useful for evaluating healthcare quality across several domains. Future work will involve assessing PediHome's construct and predictive validity.

Original languageEnglish (US)
Pages (from-to)1510-1519
Number of pages10
JournalAcademic Pediatrics
Issue number8
StatePublished - Nov 1 2022


  • access
  • children with medical complexity
  • children with special health care needs
  • home healthcare
  • quality

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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