Look Who's Talking: Comparing Perceptions Versus Direct Observations in Family-Centered Rounds

Area of Science:

• Pediatric Hospital Medicine
• Healthcare Communication
• Patient-Centered Care

Background:

• Family-centered rounds (FCR) are a recommended practice in pediatric hospital care.
• Effective communication during FCR is crucial for optimal patient and family engagement.
• Discrepancies between perceived and actual communication dynamics can impact care quality.

Purpose of the Study:

• To compare direct observations of communication during FCR with healthcare teams' perceptions and ideals.
• To identify specific areas of misalignment in time allocation and speaker dominance during FCR.
• To inform strategies for improving communication and engagement in pediatric hospital settings.

Main Methods:

• Direct observation of 30 FCR sessions (234 encounters) over 12 weeks.
• Systematic recording of speaker, time in room, and presence of nurses and family.
• Anonymous surveys assessing perceptions of time usage and desired communication patterns.

Main Results:

• Attending physicians were the primary speakers (30.8%), while nurses spoke the least (2%).
• Physicians spoke for 25.6% of time in rooms, comparable to families/patients (23.0%).
• Teams underestimated physician speaking time and overestimated family/nurse participation, desiring increased involvement from the latter.

Conclusions:

• Healthcare teams' perceptions of FCR communication do not align with observed realities.
• There is a desire for reduced physician talk time and increased family and nurse participation.
• Addressing these perception gaps is essential for enhancing the effectiveness of FCR.