Background: Family and patient-centered rounds (FPCR) are standard practice on inpatient pediatric care teams. FPCR involves the patient and an additional support person (e.g. family member) in the rounding process. FPCR benefits patient care through improved patient satisfaction; increased provider-patient communication; more frequent care-coordination and discharge planning; and decreased errors and episodes of low-value care. Despite the benefits in pediatric populations, there are limited instances of FPCR in the adult care setting. FPCR, however, is an easily translatable innovation for patients in the adult inpatient setting that has the potential to improve the value of care patients receive.
Purpose: The aim of this project was to innovate FPCR for adult patients on an acute inpatient medicine service to improve high-value care and patient satisfaction.
Description: A multidisciplinary team of hospitalists, nurses, and members of the patient experience team, led by two medical students was assembled. A needs assessment was conducted and the setting of this project was narrowed to adult patients on acute inpatient medicine services. Support was gained from the Director of Acute Care Services and Chair of Hospital Medicine to implement the FPCR process. A systematic checklist was created to facilitate introduction of the FPCR process (Image 1). The project was presented to the patient and family council, nursing council, and hospital medicine team meetings. Prompts were placed on all patient room whiteboards on the acute care unit to remind providers to call support contacts during the rounding process when a patient opts in to FPCR, and use of FPCR is documented in the electronic medical record. The primary endpoint is patient and provider satisfaction with family and patient-centered rounds. Secondary outcomes are related to factors of high-value care including improved communication, discussion of patient’s social determinants of health, increased patient inclusion in care, more appropriate and timely discharge planning, and better comprehension of medications and follow-up plans. Endpoints will be evaluated through survey collection upon discharge of participating patients and interval surveying providers utilizing FPCR. Initial feedback from providers and patients using FPCR have been positive. The process, while initially involving more time, has shown to save providers time during rounding and increase communication with patients and value of care.
Conclusions: FPCR in adult medicine is a novel concept that has the potential to increase value in patient care. The inclusion of a support person in the rounding process can help decrease repetitive testing, improve discharge planning, unify patients and their support system with the healthcare team, and improve adherence to overall care plans. FPCR may initially require an increased time investment in the rounding process. However, it has utility to improve outcomes that influence value-care and overall patient and provider satisfaction, making the investment worthwhile.
