Family-Centered Rounds

Family-Centered Rounds - A Survey of Current Practices in Pediatric Units

Vineeta S. Mittal, Ted Sigrest, Mary C. Ottolini, Daniel Rauch, Hua Lin, Brian Kit, Christopher P. Landrigan, and Glenn Flores
Family-Centered Rounds on Pediatric Wards: A PRIS Network Survey of US and Canadian Hospitalists . Pediatrics 2010 126: 37-43. Pediatrics. Pubmed

OBJECTIVE The goal was to examine pediatric hospitalist rounding practices and characteristics associated with programs conducting family-centered rounds (FCRs).
METHODS The Pediatric Hospitalist Triennial Survey, sent to a subset of pediatric hospitalists on the Pediatric Research in Inpatient Settings listserv from the United States and Canada, consisted of 63 questions on sociodemographic characteristics, training, practice characteristics, and rounding practices.
RESULTS Among 265 respondents (response rate: 70%), 78% practiced in academic hospitals and 22% in nonacademic hospitals. The prevalences of specific rounding categories were as follows: FCRs, 44%; sit-down, 24%; hallway, 21%; others, 11%. FCRs occurred significantly more often in academic (48%) than nonacademic (31%) hospitals (P = .04). FCRs can include pediatric residents, bedside nurses, charge nurses, case managers, pharmacists, and social workers. Academic settings and higher average daily patient censuses, but not FCRs, were significantly associated with prolonged rounding duration. The most commonly perceived FCR benefits included increased family involvement and understanding, trainee role modeling, and effective team communication. Physical constraints, trainees' apprehensions, and time were the main perceived FCR barriers. Greater perceived benefit/barrier ratios, FCR benefits, and family involvement in care were associated with a greater likelihood of conducting FCRs, whereas a greater number of perceived FCR barriers was associated with not conducting FCRs.
CONCLUSIONS FCRs were the most-common rounding category among respondents. FCRs were not associated with a self-reported increase in rounding duration. Successful FCR implementation may require educating staff members and trainees about FCR benefits and addressing FCR barriers.

Comments: Though not a new subject, this article attempts to assess current practices in various pediatric settings in both Canada and the U.S. This article also reports on perceived barriers and benefits of conducting family-centered rounds. Would be interesting to share practices related to involving families in multi-disciplinary rounds in neonatal intensive care units in this collaborative. For those centers who have recently implemented family-centered rounds, how were the perceived barriers overcome?. Post a comment about strategies and lessons learned from this change. What has worked well through this process? Joanna Celenza

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