Dataset Information

Family, nurse, and physician beliefs on family-centered rounds: A 21-site study.

ABSTRACT:

Background

Variation exists in family-centered rounds (FCR).

Objective

We sought to understand patient/family and clinician FCR beliefs/attitudes and practices to support implementation efforts.

Designs, settings and participants

Patients/families and clinicians at 21 geographically diverse US community/academic pediatric teaching hospitals participated in a prospective cohort dissemination and implementation study.

Intervention

We inquired about rounding beliefs/attitudes, practices, and demographics using a 26-question survey coproduced with family/nurse/attending-physician collaborators, informed by prior research and the Consolidated Framework for Implementation Research.

Main outcome and measures

Out of 2578 individuals, 1647 (64%) responded to the survey; of these, 1313 respondents participated in FCR and were included in analyses (616 patients/families, 243 nurses, 285 resident physicians, and 169 attending physicians). Beliefs/attitudes regarding the importance of FCR elements varied by role, with resident physicians rating the importance of several FCR elements lower than others. For example, on adjusted multivariable analysis, attending physicians (odds ratio [OR] 3.0, 95% confidence interval [95% CI] 1.2-7.8) and nurses (OR 3.1, 95% CI 1.3-7.4) were much more likely than resident physicians to report family participation on rounds as very/extremely important. Clinician support for key FCR elements was higher than self-reported practice (e.g., 88% believed family participation was important on rounds; 68% reported it often/always occurred). In practice, key elements of FCR were reported to often/always occur only 23%-70% of the time.

Result

Support for nurse and family participation in FCR is high among clinicians but varies by role. Physicians, particularly resident physicians, endorse several FCR elements as less important than nurses and patients/families. The gap between attitudes and practice and between clinician types suggests that attitudinal, structural, and cultural barriers impede FCR.

SUBMITTER: Patel SJ

PROVIDER: S-EPMC10087029 | biostudies-literature | 2022 Dec

REPOSITORIES: biostudies-literature

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Publications

Family, nurse, and physician beliefs on family-centered rounds: A 21-site study.

Patel Shilpa J SJ Khan Alisa A Bass Ellen J EJ Graham Dionne D Baird Jennifer J Anderson Michele M Calaman Sharon S Cray Sharon S Destino Lauren L Fegley April A Goldstein Jenna J Johnson Tyler T Johnson Tyler T Kocolas Irene I Lewis Kheyandra D KD Liss Isabella I Markle Peggy P O'Toole Jennifer K JK Rosenbluth Glenn G Srivastava Raj R Vara Tiffany T Landrigan Christopher P CP Spector Nancy D ND Knighton Andrew J AJ

Journal of hospital medicine 20220921 12

<h4>Background</h4>Variation exists in family-centered rounds (FCR).<h4>Objective</h4>We sought to understand patient/family and clinician FCR beliefs/attitudes and practices to support implementation efforts.<h4>Designs, settings and participants</h4>Patients/families and clinicians at 21 geographically diverse US community/academic pediatric teaching hospitals participated in a prospective cohort dissemination and implementation study.<h4>Intervention</h4>We inquired about rounding beliefs/att ...[more]

PMID: 36131598

Similar Datasets

Project description:BackgroundEffective communication in transitions between healthcare team members is associated with improved patient safety and experience through a clinically meaningful reduction in serious safety events. Family-centered rounds (FCR) can serve a critical role in interprofessional and patient-family communication. Despite widespread support, FCRs are not utilized consistently in many institutions. Structured FCR approaches may prove beneficial in increasing FCR use but should address organizational challenges. The purpose of this study was to identify intervention, individual, and contextual determinants of high adherence to common elements of structured FCR in pediatric inpatient units during the implementation phase of a large multi-site study implementing a structured FCR approach.MethodsWe performed an explanatory sequential mixed methods study from September 2019 to October 2020 to evaluate the variation in structured FCR adherence across 21 pediatric inpatient units. We analyzed 24 key informant interviews of supervising physician faculty, physician learners, nurses, site administrators, and project leaders at 3 sites using a qualitative content analysis paradigm to investigate site variation in FCR use. We classified implementation determinants based on the Consolidated Framework for Implementation Research.ResultsProvisional measurements of adherence demonstrated considerable variation in structured FCR use across sites at a median time of 5 months into the implementation. Consistent findings across all three sites included generally positive clinician beliefs regarding the use of FCR and structured rounding approaches, benefits to learner self-efficacy, and potential efficiency gains derived through greater rounds standardization, as well as persistent challenges with nurse engagement and interaction on rounds and coordination and use of resources for families with limited English proficiency.ConclusionsStudies during implementation to identify determinants to high adherence can provide generalizable knowledge regarding implementation determinants that may be difficult to predict prior to implementation, guide adaptation during the implementation, and inform sustainment strategies.

Project description:ObjectivesPatients speaking a primary language other than English face barriers to equitable care, particularly patient-provider communications. There is no gold standard for providing inpatient medical interpretation on family-centered rounds (FCR). We aimed to implement simultaneous, in-person interpretation of FCR for Spanish-speaking families and hypothesized improved satisfaction in care.MethodsIn-person, Spanish Equipment-Assisted Simultaneous Medical Interpretation (EASMI) was implemented in March 2018 on FCR. Child Hospital Consumer Assessment of Healthcare Providers and Systems (Child HCAHPS) experience scores on communication domains were analyzed for Spanish and English-speaking families pre- (n = 118) and postimplementation (n = 552). Postimplementation, we conducted medical team surveys (n = 104) and semistructured interviews with Spanish-speaking families (n = 25) to determine satisfaction with interpretation modalities (phone, video, and EASMI).ResultsSpanish-speaking families exhibited statistically significant improvements in Child HCAHPS top box scores compared to English-speaking families in multiple communication and informed care-related domains. For example, "How often did your child's doctors explain things to you in a way that was easy to understand?" top box scores improved from 58% to 95% for Spanish-speaking families, compared to 85% to 83% for English speakers, with the differential effect of the intervention showing statistical significance (P = .001). Medical team surveys demonstrated high satisfaction with EASMI. Qualitative themes from interviews and open-ended survey responses emphasized multiple care benefits with EASMI, including a perceived reduction of communication errors and increased family participation.ConclusionsEASMI was associated with significant improvements in Child HCAHPS scores in communication domains and increased medical team and family members' satisfaction with interpretation. EASMI presents a novel method for equitable FCR for Spanish-speaking families.

Dataset Information

Family, nurse, and physician beliefs on family-centered rounds: A 21-site study.

Background

Objective

Designs, settings and participants

Intervention

Main outcome and measures

Result

Publications

Family, nurse, and physician beliefs on family-centered rounds: A 21-site study.

Similar Datasets

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