Purpose: To develop and test a questionnaire to identify situations among patients, families, and providers that lead to complex pediatric medical care in a tertiary hospital setting.
Design: A mixed methods approach was used. Qualitative content analysis of hospital documents was conducted to develop questionnaire items. Psychometric analyses were used to measure reliability, and factor analysis was used to reduce instrument length.
Results: A 54-item questionnaire with 11 categories was distributed to 205 nurses and medical staff. Psychometric analysis of responses identified a final refined tool with 31 items comprised of six factors.
Practice implications: The Red Flags Situation Assessment Tool can be used to identify complex care situations and address them earlier in a hospital course to avoid challenges to providing patient- and family-centered care.
Keywords: Complex care; patient- and family-centered care; “difficult” patient and/or family.
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