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.
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.
Authors: Liang R Cui; Megan LaPorte; Matthew Civitello; Meg Stanger; Maxine Orringer; Frank Casey; Bradley A Kuch; Sue R Beers; Cynthia A Valenta; Patrick M Kochanek; Amy J Houtrow; Ericka L Fink Journal: J Crit Care Date: 2017-03-07 Impact factor: 3.425
Authors: Mithya Lewis-Newby; Deborah E Sellers; Elaine C Meyer; Mildred Z Solomon; David Zurakowski; Robert D Truog Journal: J Palliat Med Date: 2020-03-17 Impact factor: 2.947
Authors: Merrick Lopez; Yana Vaks; Michele Wilson; Kenneth Mitchell; Christina Lee; Janeth Ejike; Grace Oei; Danny Kaufman; Jamie Hambly; Cynthia Tinsley; Thomas Bahk; Carlos Samayoa; James Pappas; Shamel Abd-Allah Journal: Pediatr Qual Saf Date: 2019-05-16