In the Journals

Family inclusion in pediatric rounds improves parental satisfaction with care

Many parents who have the opportunity to participate in family-centered rounding, which includes parental involvement with multidisciplinary rounds at their child’s bedside, report positive experiences with the process when compared with standard rounds, according to a review published in Pediatrics.

“Many pediatric institutions have adopted family-centered rounding as standard care, resulting in shortened stays, earlier discharges, reduced costs and improved provider satisfaction,” Kelly E. Rea, BA, from the department of pediatrics at the University of Michigan, and colleagues wrote. “Researchers suggest that family-centered rounding improves the medical team’s understanding of the care plan, physician comfort with clinical dilemmas and collaboration between team members.”

To evaluate family-centered rounding through patient and family experiences, the researchers conducted an analysis of data collected from PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Embase. All data included in the study were published in English between January 2007 and February 2017 in a peer-reviewed journal.

Data concerning patients aged between 0 and 21 years, as well as detailed measurements of family experiences with family-centered rounding also were incorporated. Specific information included sample size, the medical units that participated in family-centered rounding, family experiences and overall results related to family experience.

Twenty-eight studies met inclusion criteria. Five of the studies analyzed for parent satisfaction with family-centered rounding and observed high rates of satisfaction and desire for inclusion. One study demonstrated that 90% of parents preferred to be present during their child’s rounds within a pediatric ICU. Additionally, it was also observed that 97% of parents were interested in attending their child’s rounds and 98% enjoyed the process. The inclusion of the family increased many parents’ satisfaction in the health care their child received (81%).

However, findings regarding satisfaction varied across studies, with some reporting no significant differences between family-centered rounding and standard rounds when a comparator was available.

When compared with standard rounds, satisfaction with family-centered rounding was not as clear. One study that included 63 parents of infants in a NICU demonstrated that 95.2% would rather be included as compared with standard rounds and that the process increased parental knowledge and understanding. Another sample group demonstrated that when their children were in inpatient settings, parents reported higher satisfaction with their child’s health care. Although participating in family-centered rounding was not a determining factor of satisfaction in the NICU setting, it increased communication.

Of the parents who participated in family-centered rounds with children in the NICU, self-reported knowledge and understanding of care was significantly higher and reported that discussion bedside provided them the opportunity to ask questions.  All reported that they were also able to discuss the plan of care for their child, compared with only half of parents reporting this planning during standard rounds.

Furthermore, this process was supported by all parents of 18 children within a hematology-oncology unit with a desire to continue family-centered rounds in the future. In a study that included 100 parents of children in medical and/or surgical ICUs who participated in family-centered rounding, parents who attended the process were more likely to report that families should be included.

“On the basis of these results, we believe it is unclear whether family-centered rounding has an impact on satisfaction compared with standard rounds,” Rea and colleagues wrote. “It will be essential for researchers of future studies to use the results of this review to determine the ways satisfaction may differ between samples and settings, as well as further examine the effects of family-centered rounding versus standard rounds.” – by Katherine Bortz

Disclosure: The authors report no relevant financial disclosures.

Many parents who have the opportunity to participate in family-centered rounding, which includes parental involvement with multidisciplinary rounds at their child’s bedside, report positive experiences with the process when compared with standard rounds, according to a review published in Pediatrics.

“Many pediatric institutions have adopted family-centered rounding as standard care, resulting in shortened stays, earlier discharges, reduced costs and improved provider satisfaction,” Kelly E. Rea, BA, from the department of pediatrics at the University of Michigan, and colleagues wrote. “Researchers suggest that family-centered rounding improves the medical team’s understanding of the care plan, physician comfort with clinical dilemmas and collaboration between team members.”

To evaluate family-centered rounding through patient and family experiences, the researchers conducted an analysis of data collected from PubMed, Cumulative Index to Nursing and Allied Health Literature, PsycINFO, Scopus and Embase. All data included in the study were published in English between January 2007 and February 2017 in a peer-reviewed journal.

Data concerning patients aged between 0 and 21 years, as well as detailed measurements of family experiences with family-centered rounding also were incorporated. Specific information included sample size, the medical units that participated in family-centered rounding, family experiences and overall results related to family experience.

Twenty-eight studies met inclusion criteria. Five of the studies analyzed for parent satisfaction with family-centered rounding and observed high rates of satisfaction and desire for inclusion. One study demonstrated that 90% of parents preferred to be present during their child’s rounds within a pediatric ICU. Additionally, it was also observed that 97% of parents were interested in attending their child’s rounds and 98% enjoyed the process. The inclusion of the family increased many parents’ satisfaction in the health care their child received (81%).

However, findings regarding satisfaction varied across studies, with some reporting no significant differences between family-centered rounding and standard rounds when a comparator was available.

When compared with standard rounds, satisfaction with family-centered rounding was not as clear. One study that included 63 parents of infants in a NICU demonstrated that 95.2% would rather be included as compared with standard rounds and that the process increased parental knowledge and understanding. Another sample group demonstrated that when their children were in inpatient settings, parents reported higher satisfaction with their child’s health care. Although participating in family-centered rounding was not a determining factor of satisfaction in the NICU setting, it increased communication.

Of the parents who participated in family-centered rounds with children in the NICU, self-reported knowledge and understanding of care was significantly higher and reported that discussion bedside provided them the opportunity to ask questions.  All reported that they were also able to discuss the plan of care for their child, compared with only half of parents reporting this planning during standard rounds.

Furthermore, this process was supported by all parents of 18 children within a hematology-oncology unit with a desire to continue family-centered rounds in the future. In a study that included 100 parents of children in medical and/or surgical ICUs who participated in family-centered rounding, parents who attended the process were more likely to report that families should be included.

“On the basis of these results, we believe it is unclear whether family-centered rounding has an impact on satisfaction compared with standard rounds,” Rea and colleagues wrote. “It will be essential for researchers of future studies to use the results of this review to determine the ways satisfaction may differ between samples and settings, as well as further examine the effects of family-centered rounding versus standard rounds.” – by Katherine Bortz

Disclosure: The authors report no relevant financial disclosures.