Table 2.

Predicted Challenges of Sharing Inpatient Notes With Parents, Definitions, and Exemplary Quotes

Challenge	Definition	Quote
Increasing provider workload	Note sharing leading to increased provider workload	“Right now, we work 16 hours… and now if you’re going to add on top of that having to run to the parents’ bedside to explain our note, that’s going to delay all our other responsibilities. And if you are going to add extra documentation, like that’s going to be more work that we aren’t necessarily going to have time to do.”
Heightening parental distress and/or anxiety	Note content causing heightened parental distress, anxiety, worry and/or anger	“Do I really need to see all the notes at that point where they’re discussing every possibility that could be going on with him and the tests that they need to run? Because given that state of mind, I, it’s, you know, after a diagnosis is made…I know that I went into an anxiety attack.”
Causing parental confusion	Note content causing parental confusion due to medical jargon and/or ambiguity	“ You know, families should know what’s going on. But do they? Are they able to understand the level of ambiguity, uncertainty that sometimes comes in these inpatient settings, especially for really complicated patients?”
Impairing parent-provider relationship	Some note content leading to distrust or an impaired relationship between patients, families, and providers	“It would make me have less trust for that particular doctor if I’m looking at your notes and I know that you’re cutting and pasting or you’re not putting in accurate information. That changes what I think of our relationship and whether or not I can trust that you’re doing your job accurately.”
Compromising note quality and/or purpose	Alterations of notes for parent viewing resulting in compromised quality and/or purpose	“I was also wondering, in the challenges, whether it could inhibit doctors from talking freely to each other knowing that the parents are privy to [notes].”