Child, Hospitalized, Delivery of Health Care, Morning Rounds
Conditions
Keywords
Morning Rounds, Patient-centered Care, Hospital Medicine, Pediatrics, Hospitals, Pediatric
Brief summary
The goal of this study is to develop, implement, and evaluate the effectiveness of an intervention designed to facilitate family engagement during bedside rounds at a children's hospital. The intervention consists of a checklist of key behaviors associated with the delivery of quality family-centered rounds, as well as training in the use of the checklist tool. In a pre-post controlled design, two hospital services will be randomized to use the checklist while two others will be randomized to usual care. The intervention is expected to increase to the performance of key checklist behaviors, family engagement, and family perceptions of patient safety.
Detailed description
Family engagement in children's healthcare encounters has been suggested as a means to improve safety. To engage families in care, the recommended practice is to conduct rounds at the child's bedside with the family present (family-centered rounds). Family-centered rounds strive to engage families in (1) a relationship with care providers, (2) exchange of information for decision making, and (3) deliberation about decisions. Bedside rounds represent a consistent venue to engage families in the care of hospitalized children, yet no studies have systematically identified and examined the barriers and facilitators of family engagement during rounds as a means to improve safety.
Interventions
OTHERFamily-centered rounds checklist tool
A printed checklist containing 9 key tasks associated with effective delivery of family-centered rounds. A previously-identified member of each rounding team was responsible for holding the printed checklist during morning rounds. Team members were trained the in the use of this checklist prior to the post-intervention period, and a brief refresher training was conducted mid-way through the period.
Sponsors
Agency for Healthcare Research and Quality (AHRQ)
University of Wisconsin, Madison
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Subject)
Eligibility
Sex/Gender
ALL
Age
No minimum to 17 Years
Healthy volunteers
Yes
Inclusion criteria
* Admitted as an inpatient on the pediatric hospitalist service, pulmonary service, or hematology/oncology service, during the study period.
Exclusion criteria
* Stigmatizing/sensitive reason for hospitalization (e.g., suspected non-accidental trauma or mental health concerns) * New cancer diagnosis * Parent(s) unable to speak or read English * Parent(s) unavailable to consent (absent or sleeping during recruitment visits) * Already participated in the study during a prior inpatient admission
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Parent perceptions of hospital safety climate | Change between baseline (inpatient admission) and study completion (discharge from hospital, an average of 6 days) | Children's Hospital Safety Climate survey |
| Family engagement in rounds | Every family-centered morning round that occurred during the patient's hospital stay through study completion, an average of 6 days | Video data was collected for every morning round over the course of the patient's hospital stay. These videos were coded for measures of family engagement in rounds using established and validated coding systems (e.g. RIAS). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Checklist item performance | Every family-centered morning round that occurred during the patient's hospital stay through study completion, an average of 6 days | Assessment of how many key checklist elements were performed during each family-centered round (coded from video recordings of each round). |
Countries
United States
Outcome results
None listed