Providing family-centered care in pediatric emergency medicine poses unique challenges. Established relationships between patients, their families, and health care providers are lacking, and contact with health care providers is often short and intense. In 2007, the Institute of Medicine emphasized the importance of integrating patient- and family-centered with emergency care for children. However, a barrier to improving the quality of pediatric emergency family-centered care is that a comprehensive and validated measure does not exist. A basic tenet of quality improvement science is that we cannot improve what we do not measure. The long-term goal is to improve the quality of care in pediatric emergency medicine by improving the delivery of family-centered care. The overall objective of this R03 application is to develop preliminary data that will provide focus and direction for the subsequent development of a validated measure of the quality of family-centered care for children presenting in pediatric emergency department settings. The central hypothesis is that the dimensions of patient-centered adult care that currently exist in the literature will have to be modified to reflect the unique challenges of pediatric emergency medicine. The rationale for this work is that once it is known how to measure the quality of family-centered care, targeted interventions can be developed that will improve the efficiency and quality of care in pediatric emergency rooms. The overall objective will be achieved through the pursuit of two specific aims. Specific Aim #1: Identify and define dimensions of family-centered care in pediatric emergency medicine that are most important to families. This will be accomplished through literature review and focus groups with parents. Specific Aim #2: Develop questions that measure the dimensions of the quality of family-centered care in pediatric emergency settings. This will be accomplished by using the qualitative data from the focus groups and conducting cognitive interviews with parents. This project is innovative because, unlike previous studies in pediatric emergency medicine that have explored components of family-centered care such as pain management and family presence, this project takes a global and comprehensive approach to measuring family-centered care. This is absolutely essential for the development and testing of interventions to improve the quality of family- centered care in pediatric emergency medicine. The significance of the proposed research is that its results are expected to provide direction and focus for subsequent definitive studies at the R01 level to develop a validated measure of the quality of family-centered care in pediatric emergency medicine. A validated measure is critical for advancing and improving family-centered care in pediatric emergency medicine. It will provide a tool to test quality improvement interventions and ultimately explore the relationships between family-centered care and outcomes. PUBLIC HEALTH RELEVANCE: The proposed project is relevant to public health because it will result in preliminary data that will provide focus and direction for the subsequent development of a validated measure of the quality of family-centered care in pediatric emergency care settings. While previous studies have examined some components of family-centered care, this study takes a global and comprehensive approach. This is essential to improving the delivery of family-centered emergency care for children because once it is known how to comprehensively measure it, targeted interventions to improve it can be developed and tested.