Family‐Centered Rounds: A Comparison of Pediatric Hospitalists in Nonacademic and Academic Hospitals

Background:

Patient‐centered care is an aim of quality care identified by the Institute of Medicine. The American Academy of Pediatrics has issued recommendations for family‐centered care, including conducting rounds with the family present. To date, there have been few published studies examining the experiences of nonacademic hospitals with family‐centered rounds (FCRs).

Methods:

A cross‐sectional survey of pediatric hospitalists was administered as part of the Pediatric Research in Inpatient Settings (PRIS) Triennial Survey. Data collection occurred online through Survey Monkey . Respondents' academic classification and rounding structure were compared using chi‐square analysis. Likewise, perceived benefits and barriers of FCR between nonacademic hospitalists (NAHs) and academic hospitalists (AHs) were compared using chi‐square analysis.

Results:

There were 207 respondents to the PRIS survey, of which 180 competed the study questions. Although most NAHs rounded with someone else (90%), NAHs differed in the rounding structure employed compared with AHs (P = .002). NAHs were more likely to conduct rounds as a “sit down” in a conference room, whereas the largest proportion of AHs were family centered. NAHs spent less time rounding and had a lower patient volume than AHs (both P < .0001). NAHs and AHs differed in their perception of the benefits and barriers to FCR. NAHs were less likely to identify effective team communication (32% vs. 86%, P = .015), role modeling for trainees (56% versus 86%, P = .0001), and efficient discharge/work flow as benefits of FCRs (37% versus 67%, P = .0007). NAHs were more likely to identify the impact on nurse flow (44% versus 25%, P = .034). NAHs were less likely to identify trainee fear of loss of families' respect if not knowledgeable (20% versus 53%, P = .0004), inefficiency from extension of rounds because of increased parental questions (24% versus 45%, P = .026), and room size (15% versus 63%, P = .0001) as barriers to FCRs.

Conclusions:

NAHs and AHs differed in their implementation and perceptions of FCRs and had significant differences in time spent rounding as well as patient volume. These differences may explain the different perceived barriers to and benefits of FCRs. These differences must be accounted for by strategies to implement FCRs in nonacademic hospitals.

Author Disclosure:

B. Kit, none; D. Rauch, none; V. Mittal, none; T. Sigrest, none; M. Ottolini, none.