Family-Centered Rounds on Pediatric Wards: A PRIS Network Survey of US and Canadian Hospitalists -- Mittal et al. 126 (1): 37 -- Pediatrics

Published online June 29, 2010
PEDIATRICS Vol. 126 No. 1 July 2010, pp. 37-43 (doi:10.1542/peds.2009-2364) This Article

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ARTICLES

Family-Centered Rounds on Pediatric Wards: A PRIS Network Survey of US and Canadian Hospitalists
Vineeta S. Mittal, MDa,b, Ted Sigrest, MDc, Mary C. Ottolini, MD, MPHd,e, Daniel Rauch, MDf, Hua Lin, PhDa, Brian Kit, MDd,e, Christopher P. Landrigan, MD, MPHg,h,i,j, Glenn Flores, MDa,b

a Division of General Pediatrics, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas;
b Department of Pediatrics, Children's Medical Center, Dallas, Texas;
c Department of Pediatrics, Cincinnati Childrens Hospital Medical Center, Cincinnati, Ohio;
d Department of Pediatrics, Children's National Medical Center, Washington, DC;
e Department of Pediatrics, School of Medicine, George Washington University, Washington, DC;
f Department of Pediatrics, School of Medicine, Mount Sinai, New York, New York;
g Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts;
h Department of Medicine, Children's Hospital Boston, Boston, Massachusetts; and
Departments of i Pediatrics and
j Medicine, School of Medicine, Harvard University, Boston, Massachusetts

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.



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Key Words: patient-centered care • bedside rounds • hospitalization • medical education

Abbreviations: FCR = family-centered round • PRIS = Pediatric Research in Inpatient Settings • AAP = American Academy of Pediatrics

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Accepted Mar 10, 2010.
Family-Centered Rounds on Pediatric Wards: A PRIS Network Survey of US and Canadian Hospitalists -- Mittal et al. 126 (1): 37 -- Pediatrics