Effective communication between healthcare providers, children, and their caregivers minimizes unnecessary anxiety and stress, fostering a positive patient experience (Weng et al., 2024). This is underscored by the World Health Organization, which has indicated that effective communication and meaningful participation are fundamental rights of every child and critical elements of quality healthcare (World Health Organization, 2018). The Consumer Assessment of Healthcare Providers and Systems Child Hospital Survey (Child HCAHPS) serves as a tool to assess the experience of pediatric patients and their families during hospitalization. It encompasses various aspects, including communication with caregivers and attention to safety and comfort (Toomey et al., 2017). Effective communication during hospital admission processes is a top priority for pediatric caregivers (Leyenaar et al., 2018; Leyenaar et al., 2023). However, there remains a lack of understanding regarding the gaps in communication during the hospital admission process. Therefore, identifying communication gaps in pediatric hospitalization enables the development of targeted intervention strategies to enhance healthcare outcomes.

The admission care process is defined as the initial nursing assessment of a child's health needs at hospital admission (Diaz-Caneja et al., 2005). Hospital admission, comparable to discharge, can generate substantial stress for patients and their families (Leyenaar et al., 2017). Although significant efforts have focused on improving the quality and safety of hospital discharge processes and transitions to home (Auger et al., 2014; Kripalani et al., 2014), guidance analogous to discharge improvement remains limited for hospital admission processes, particularly regarding communication. A limited number of studies have examined quality improvement in emergency department admissions (Hannon et al., 2022; Huy et al., 2021; Schreiner et al., 2025). Zahra et al.'s interventional study demonstrated that enhanced admission communication improves parental satisfaction with pediatric care (Hoodbhoy et al., 2020). While the current literature offers limited insights into the deficits prevalent in admission communication for pediatric inpatients, as well as the strategies to conduct it efficiently.

Failure Mode and Effects Analysis (FMEA) is a proactive risk assessment methodology that systematically identifies potential failure modes in systems, processes, products, or services, analyzes their causes and effects, and implements mitigation strategies to address the most critical risks (Ashley et al., 2010). It is increasingly being adopted as a valuable tool in healthcare settings (Anjalee et al., 2021; Lin et al., 2022; Maughan et al., 2022; Prieto-Molina et al., 2023). A recent comprehensive review documented the application of FMEA (Failure Mode and Effects Analysis) across diverse healthcare domains, including the blood transfusion process, medication use, radiation therapy, hospital management, and information systems (Anjalee et al., 2021; Liu et al., 2020). FMEA principles were employed to identify communication weaknesses within the emergency department setting (Bagnasco et al., 2013; Blackburn et al., 2019; Redfern et al., 2009), and this approach revealed higher-priority failure modes in the communication process. These results demonstrate that FMEA, a simple yet effective tool for problem analysis and prioritization, holds significant value for healthcare quality improvement and error reduction, thereby underpinning its widespread adoption in hospital process enhancement. Nonetheless, we know very little about applying FMEA to admission communication in hospitalized patients, especially pediatric inpatients. Identifying high-risk domains in admission communication for pediatric inpatients could inform targeted improvement strategies, ultimately enhancing the care experience for patients and their families.

This study aimed to describe the admission communication processes for pediatric inpatients, identify points of vulnerability, and develop evidence-based improvement strategies.