Family as a member of the trauma rounds: a strategy for maximized communication

In many hospital settings, the process of providing information to families of critically ill and injured patients can be frustrating for all concerned. Communication failure is the root of much dysfunction in health care and improvement would be well received. The Trauma Team chose to include family members in daily work rounds, allowing total access to team deliberations.

For the past two years, families have been informed at the time of admission of the patient that daily patient rounds provide an optimal venue for information exchange and that the team expected family participation. A written 25 question survey was sent to selected family participants to obtain their retrospective opinions about the process. Additionally the ICU nursing staff completed an abbreviated survey to document their perceptions as to how family rounds facilitated care.

Rounds with families have occurred daily, resulting in much improved relationships as reported by the team. Stress seems functionally diminished, hostility reduced and system dysfunction is less frequent. A total of 34 family questionnaires were available for evaluation. Parents were the most frequent participants (68%). Respondents reported having limited clinical knowledge about their family member prior to rounds but obtaining vital information from rounds which allowed them to understand the patient's condition and plans for care. No areas of dissatisfaction were documented. Sixteen respondents wrote comments which were positive in nature. Respondents from the nurse questionnaire indicated satisfaction with communication by the team and resultant facilitation of relations with the families.

Despite misgivings by some team members, the presence of family on rounds has been a success as judged by the participants. There have been no adverse events. This method of family interaction is worthy of utilization in other institutions to provide enhancement of communications with families.