FIQS Dissemination and Implementation

This study is testing Family Input for Quality and Safety (FIQS), a mobile-based survey tool that allows hospitalized children's families and adolescent patients to report safety concerns in real-time by responding to a text message link on their mobile phone. The main questions it aims to answer are: 1. Does the way families are invited to use the safety reporting survey (text-only invitation versus text plus brief in-person orientation) affect how many families participate and report safety concerns? 2. Does sharing safety reports anonymously versus with patient identifiers (for example, the patient name or room number) affect how often families report concerns and how hospitals respond? 3. What barriers and supports help hospitals successfully use the reports from the survey to make safety improvements without extensive/dedicated research infrastructure? Researchers will compare different enrollment approaches and anonymous versus identified reporting across multiple children's hospitals to see which methods work best for engagement with the FIQS tool. Participants will: * Receive automated text message invitations when their child is admitted to participating hospital units * Be randomly assigned to receive either text-only invitation or an additional brief in-person orientation * Use a mobile-responsive survey to report safety concerns during their hospital stay through daily text prompts * Be randomly assigned to have their reports shared either anonymously or with identification to help hospital staff follow up * Participate during hospitalization while hospitals learn to integrate family safety reports into their quality improvement efforts

Inclusion Criteria: * Family members or caregivers of patients (aged 0 to 21 years) admitted to participating hospital units * Patients aged 13 years and older admitted to participating hospital units * English or Spanish speakers * Patient or parent/guardian owns a mobile phone * Patient or parent/guardian present during hospitalization Exclusion Criteria: * Patients or parents/guardians who are non-English and non-Spanish speakers * Patients or parents/guardians who do not own a mobile phone * Patients admitted under sensitive services * Patients who are in the foster care system