Could You Gather ‘Round, Please?

  Two new studies suggest that the popular practice of including patients and family members during hospital rounds is gaining even greater momentum.

Family-centered rounds were the most common rounding practice among 265 U.S. and Canadian pediatric hospitalists surveyed as part of the PRIS (Pediatric Research in Inpatient Settings) Network Triennial Survey.

 The recently published survey, described as the first national study of pediatric hospitalists to identify current rounding practices, reported that 48% of academic and 31% of non-academic respondents used family-centered rounds.

The long-standing concern that having family members present would increase rounding time did not materialize, with academic setting and higher daily patient censuses being the only significant causes of longer rounding duration.

 This finding contradicts previous research and “may be used to enhance FCR buy-in by hospitals considering or initiating FCRs,” the authors suggest.

The most common perceived barrier to FCR, cited by 44% of respondents, was that the rounding team size was prohibitive. Other barriers include trainees’ fear of not appearing knowledgeable in front of families, a negative impact on physician work flow and patient confidentiality.

Several professional groups, including the American Academy of Pediatrics, already endorse family-centered care as a way to improve team communication and outcomes.

 Indeed, the study noted that bedside nurse participation was perceived as being significantly greater on FCR rounds than on other types such as sit-down or hallway rounds (83% vs. 51%). Considering their work in the trenches, this finding says a lot.

 In a second study, presented at the Pediatric Hospital Medicine 2010 meeting, EEGs and head MRIs were completed faster after implementation of FCR at Riley Hospital for Children in Indianapolis.

FCR also increased the percentage of discharges on the first shift, from 40% to 47% – not an insignificant amount, according to lead author Dr. Jennifer Oshimura, a pediatric hospitalist fellow at the Indianapolis-based hospital.

 “It took a little while for the whole staff to buy in,” she said in an interview. “It takes more effort for the medical students, residents and interns to know what to present. It helps for them to learn; otherwise they just spit up data.”

For anyone who’s ever been on the receiving end of that data, the effort is appreciated.

– Patrice Wendling (on Twitter @pwendl)

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1 Comment

Filed under Family Medicine, Hospital and Critical Care Medicine, IMNG, Uncategorized

One response to “Could You Gather ‘Round, Please?

  1. Jack Percelay

    Thanks for giving us the PR on this. Pediatric hospitalists are taking the lead in instituting what we call “family-centered rounds” in the hospital. This involves having the family, nurse(s) and doctor(s) in the room at the same time when the assessment and plans are made during morning rounds. The advantages are multiple. Get more information by googling “family centered rounds.” As a note, we’re pushing the term to “patient and family-centered rounds (care), indicating that this is just as valuable in the care of adults as it is in children.

    The American Academy of Pediatrics has a useful policy that addresses this and other issues under the larger rubric of family-centered care.

    Jack Percelay
    Pediatric Hospitalist

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