Research on the Global Impact of the Ronald McDonald House Program

Research on the Global Impact of the Ronald McDonald House Program

RMHC: A Global Organization Ronald McDonald House Ronald McDonald Family Room Ronald McDonald Care Mobile 357 203 49 39 countries and regions 23 countries and regions 9 countries and regions

Canada United States of America Latin America Argentina Brazil Chile Colombia Costa Rica Curacao Ecuador Guatemala Honduras Mexico Nicaragua Panama Peru Puerto Rico Trinidad & Tobago Uruguay Venezuela Europe Austria Belgium Bulgaria Czech Republic Denmark England Finland France Germany Hungary Ireland Italy Latvia Malta Netherlands Norway Poland Portugal Romania Russia Scotland Serbia Slovakia Spain Sweden Switzerland Asia Pacific / Middle East /Africa Australia China Cyprus Fiji Hong Kong India Indonesia Japan Jordan Korea Malaysia New Zealand Pakistan Philippines Singapore South Africa Taiwan Thailand Turkey UAE Vietnam

Purpose of Global Impact Research Define the role that the Ronald McDonald House program plays in the health care experience for critically-ill children and their families Patient & family involvement Patient experience/satisfaction Clinical outcomes Keeping Families Close. 4

As of November 20, 2015 Perhaps you ve heard Pubmed: Family-Centered Care = 4,775 hits Pubmed: Patient-Centered Care = 18,909 hits

A Growing Understanding of RMHC Impact, Substantiated by Research Research Progress, 2011-14 Number Global and local formal RMHC academic research projects > 10 Papers published 10 Presentations at professional meetings 9 6

Ronald McDonald Houses Enable Family-Centered Care Support Access to Care Penchansky and Thomas, 1981 Reduce Financial Burden DiFazio and Vessey, 2011 Provide Psychosocial Support Keeping Families Together Shudy et al, 2006 ; Yantzi et al, 2001 Enhance Clinical Experience and Outcomes AAP, 2011; Gooding JS et al, 2011 Help Families Resume Normalcy Davidson et al, 2012 7

Questions Added to Hospital Surveys 8

Hospital Participation 49 hospitals invited, 10 accepted, 5 with RMH N = 5,467 2,000 Total # Survey Responses by Hospital 1,500 1,000 500 - A B C D E* F* G* H* I J* Inpatient NICU 9

10 Where do pediatric families stay?

RMH Families Have the Highest Ratings of Hospitals 1.8 to 2x 2.4 to 3.4x 3 to 5x 11

Hospital Leadership Survey Goal: To document perspectives and opinions of hospital leadership regarding potential contributions of being affiliated with a Ronald McDonald House to hospital mission, operations and ability to provide familycentered care. 12

Methods All RMHs asked to provide names/email addresses of types of key administrators in main partner hospital 973 names provided by 121 RMHs Internet survey offered in English and Spanish 530 responses (19 in Spanish) 54.5% response rate Respondents from 17 countries 13

RMH Helps Families Meet the Challenges of: Percent Strongly Agreed/Agreed Feeling isolated 80.8% Getting enough sleep 79.0% Coping with child s illness 76.2% Coping with stress on the family 74.2% Receiving needed social support 73.4% Depression among parents 47.9% Depression among sick child 38.1% 14

RMH Helps Families Meet the Challenges of: Percent Strongly Agreed/Agreed Finding lodging 89.6% Paying for lodging 76.3% Taking time to eat 84.9% Paying for meals 68.5% Transportation to/from hospital 61.6% 15

Being Affiliated with a Ronald McDonald House: Enhances our ability to provide family-centered care Percent Strongly Agreed/Agreed 95.1% Reduces the stress of parents 94.0% Reduces costs to families 92.6% Improves parents sleep quality/quantity 92.2% Reduces the burden of the hospital in assisting with lodging Reduces the burden of the hospital in assisting with food 90.8% 83.9% 16

CEO Respondents (38) 100% reported that RMH affiliation enhances the provision of familycentered care, 90.6% reported it improves quality of care Medical Directors/ Clinical Leaders (65) Overall, 43.5% of respondents strongly agreed/agreed that having a RMH affiliated with hospital reduces the length of time a child stays in the hospital. This was 60% among chief medical officers or other clinical leaders 17

Hospital Length of Stay Study The purpose of this study is to investigate the influence of Ronald McDonald House accommodation on children s length of hospital stay. A RMH experience could influence hospital length of stay through two pathways. Having the family in close proximity and participating in care might help the child to heal faster or to be ready to be discharged sooner. The proximity of the House might offer additional options in terms of care or follow-up care that influence the timing of discharge. 18

Hospital Admissions Characteristics - LOS Study Kansas City Stanford Toronto RMH stays 1,040 410 485 No RMH > 30 miles 3,796 2,720 2,069 No RMH < 30 miles 8,343 4,605 5,771 Total admissions 13,179 7,735 8,325 % stayed at RMH 7.9% 5.3% 5.8% Note: Some RMH stays were of families < 30 miles and the geographic restriction for each of the Houses varies. 19

Length of Stay Comparison, by Hospital (in days) Kansas City Stanford Toronto RMH Stay 15.62 23.1 23.62 No RMH > 30 miles 4.81 8.77 7.45 NO RMH < 30 miles 4.94 8.39 8.58 20 *A small number of those with a RMH stay lived <30 miles away from the hospital

Case Mix/Resource Intensity Comparison, by Hospital Kansas City Stanford Toronto # Procedures Case Mix Resource Intensity RMH Stay 4.69 4.97 9.11 No RMH > 30 miles 1.41 2.42 2.58 No RMH < 30 miles 1.15 2.34 2.65 21 *A small number of those with a RMH stay lived <30 miles away from the hospital

Summary of LOS Study Findings RMH families Have travelled the furthest distances Have longer lengths of stay Have much sicker children Case mix # procedures # diagnoses Resource intensity 22