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Family experiences and pediatric health services use associated with family-centered rounds
Dennis Z Kuo1, Laura L Sisterhen, Ted E Sigrest
1Center for Applied Research and Evaluation, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72202, USA. dzkuo@uams.edu
Insights
Family-centered rounds (FCR) improve parent satisfaction and communication without increasing healthcare use. These interdisciplinary bedside rounds enhance family experiences during pediatric hospitalizations.
Area of Science:
- Pediatric healthcare quality
- Patient and family engagement
- Health services research
Background:
- Family-centered rounds (FCR) involve interdisciplinary bedside teaching with active family participation.
- Previous research has not fully elucidated the impact of FCR on family experiences and healthcare utilization.
Purpose of the Study:
- To investigate the association between family-centered rounds (FCR) and family experiences.
- To examine the relationship between FCR and health services use in pediatric inpatient settings.
Main Methods:
- Prospective comparative study of pediatric patients with and without FCR.
- Data collected via interviews, surveys (Consumer Assessment of Healthcare Providers and Systems), and medical record review.
- Propensity score matching used to control for confounding variables.
Main Results:
- Families participating in FCR reported significantly better consistent medical information, care plan discussion options, and perceived physician attentiveness and respect.
- No significant differences were observed in the number of medications prescribed or time of discharge between FCR and non-FCR groups.
- Hospital charges did not differ significantly after adjusting for outliers in length of stay.
Conclusions:
- Family-centered rounds are linked to enhanced parent satisfaction and improved communication.
- FCR implementation does not appear to increase the burden on health services use.
- Further research is recommended to evaluate FCR in diverse clinical settings.
Background:
Family-centered rounds (FCR) are defined as interdisciplinary bedside teaching rounds with active family participation. The objective of this study was to examine the association of FCR with family experiences and health services use.
Methods:
Prospective study comparing families with a child admitted to general pediatric inpatient services with and without FCR. The presence of FCR elements was assessed before study enrollment. Study data were obtained by an in-person interview, a follow-up phone interview <1 week after discharge, and medical record review. Family outcomes were informed by Consumer Assessment of Healthcare Providers and Systems measures. Health service use outcomes included hour of discharge, number of medications, and overall charges. Primary analyses included χ(2) and multivariate regression. Secondary analyses by using propensity score matching were performed to account for differences on observed variables.
Results:
A total of 140 of 203 eligible families were enrolled; 97 completed follow-up surveys (49 on FCR team). Compared with non-FCR, FCR families were more likely to report consistent medical information (P < .001), the option of discussing care plan (P < .001), doctors listening carefully (P < .01), and doctors showing respect (P < .001). No differences were found in number of medications (mean 2.4 vs 2.9, P = .26) or discharge time (mean 3:06 pm versus 2:43 pm, P = .39). No difference was found for hospital charges after adjusting for length of stay outliers.
Conclusions:
FCR are associated with higher parent satisfaction, consistent medical information, and care plan discussion, with no additional burden to health service use. Additional studies should assess FCR under different settings of care.
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