An Evaluation of Family-Centered Rounds in the PICU: Room for Improvement Suggested by Families and Providers*. Issue 9 (November 2015)

• Record Type: Journal Article
• Authors: Levin, Amanda B.; Fisher, Kiondra R.; Cato, Krista D.; Zurca, Adrian D.; October, Tessie W.
• Is Part Of: Pediatric critical care medicine. Volume 16:Issue 9(2015)
• Publication Date: 2015-11
• Subjects: child -- critical care -- instructional films and video -- patient-centered care -- patient satisfaction -- teaching rounds; Pediatric intensive care -- Periodicals; Pediatric emergencies -- Periodicals; 618.05
• DOI: 10.1097/PCC.0000000000000486
• Languages: English
• ISSNs: 1529-7535

Abstract

Abstract : Objective: To identify areas for improvement in family-centered rounds from both the family and provider perspectives. Design: Prospective, cross-sectional mixed-methods study, including an objective measure (direct observation of family-centered rounds) and subjective measures (surveys of English-speaking families and providers) of family-centered rounds. Setting: PICU in a single, tertiary children's hospital. Subjects: Families of children admitted to the PICU, physicians, and nurses. Interventions: None. Measurements and Main Results: Two hundred thirty-two family-centered round encounters were observed over a 10-week period. Family-centered round encounters averaged 10.5 minutes per child. Multivariable regression analysis revealed that family presence was independently associated with length of family-centered rounds ( p < 0.002) despite family talk time accounting for an average of 25 seconds (4%) of the encounter. Non–English-speaking families were less likely to attend family-centered rounds compared with English-speaking families even when physically present at the patient's bedside ( p < 0.001). Most commonly families and providers agreed that family-centered rounds keep the family informed and reported positive statements about family presence on family-centered rounds; however, PICU fellows did not agree that families provided pertinent information and nurses reported that family presence limited patient discussions. The primary advice families offered providers to improve family-centered rounds was to be more considerate and courteous, including accommodating family schedules, minimizing distractions, and limiting computer viewing. Conclusions: Family presence increased the length of family-centered rounds despite a small percentage of time spoken by families, suggesting longer rounds are due to changes in provider behavior when families are present. Also, non–English-speaking families may need more support to be able to attend and benefit from family-centered rounds. Lastly, in an era of full family-centered rounds acceptance, families and most providers, except fellows, report benefit from family presence during family-centered rounds. However, providers should be aware of the perception of their behaviors to optimize the experience for families. Abstract : Supplemental Digital Content is available in the text.