Family-centered rounds in theory and practice: an ethnographic case study

Area of Science:

• Pediatric inpatient care
• Family-centered care principles
• Clinical communication strategies

Background:

• Family-centered rounds (FCR) aim to integrate family-centered care principles into inpatient settings.
• Existing models for FCR exist, but research on their alignment with core principles is limited.

Purpose of the Study:

• To evaluate how current Family-centered rounds (FCR) practices align with established principles of family-centered care.
• To identify gaps between FCR implementation and the ideals of family involvement in pediatric care.

Main Methods:

• An ethnographic study involving over 200 hours of observation of FCR on a general pediatrics unit.
• Qualitative analysis of observations (185 rounding events) and interviews with 6 family members.
• The principles of family-centered care were used as a lens for thematic analysis.

Main Results:

• FCR facilitated information sharing, but medical jargon posed a communication barrier.
• While teams intended to show respect, contextual factors sometimes hindered this.
• Family members had opportunities to participate but were not always actively involved.
• FCR initiated collaboration on care plans, but guaranteed collaboration did not always occur.

Conclusions:

• Family-centered rounds (FCR) can initiate family-centered care but do not inherently guarantee its principles are met.
• Physical, organizational, and cultural factors significantly impact the effectiveness of FCR and family engagement.
• Future FCR efforts should address these factors to improve alignment with family-centered care ideals.