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The Effect of Family Presence on Rounding Duration in the PICU
Priya R Gupta1,2, R Serene Perkins3, Rebecca L Hascall1,2
1Northwest Pediatric Critical Care, Portland, Oregon.
Insights
Family-centered rounds in pediatric intensive care units (PICUs) increase patient rounding time by an average of 1.3 minutes per patient. However, these family-centered care benefits may outweigh the extended duration of rounds.
Area of Science:
- Pediatric critical care medicine
- Healthcare workflow optimization
- Family-centered care models
Background:
- Family-centered rounds are now standard practice in US pediatric intensive care units (PICUs).
- Institutions are evaluating the impact of family presence during clinical rounds.
Purpose of the Study:
- To compare patient rounding times in a PICU with and without family members present.
- To determine the effect of family presence on total rounding time and overall workflow.
Main Methods:
- An observational study analyzed 2657 patient encounters over 17 months.
- Data collected included family presence, intubation status, and healthcare team composition.
- Per-patient rounding time was analyzed, controlling for influential variables.
Main Results:
- Family members were present in 66% of observed rounding encounters.
- Average per-patient rounding time was 8.6 minutes with family present versus 7.3 minutes without.
- Family presence was significantly associated with a 20.4% increase in per-patient rounding time (P < .001).
Conclusions:
- The presence of family members significantly increases per-patient rounding times in the PICU.
- Potential benefits of family presence during rounds may justify the additional time investment.
Background And Objective:
The incorporation of family-centered rounds has become standard in PICUs across the United States. We compared rounding times in our institution, with and without family members present, to determine the effect on total rounding time and work flow.
Methods:
This observational study of a convenience sample was conducted over a 17-month period (May 2014-October 2015), accounting for typical seasonal variation in the PICU. The individual patient rounding times for 2657 encounters were recorded. The presence of family members, intubation status, physician assistant participation, interruptions during rounds, attending physician's full- or part-time status, and patient census were documented. The effect of family presence on per-patient rounding time was analyzed, while controlling for influential variables.
Results:
Family members were present during 1743 of 2657 (66%) rounding encounters. The average per-patient rounding time with and without family members present was 8.6 minutes and 7.3 minutes, respectively, a difference of 1.3 minutes per patient. In statistical models that accounted for other influential variables, the presence of family members was associated with a highly significant (20.4%, P < .001) increase in the per-patient rounding time.
Conclusions:
The presence of family members increases per-patient rounding times in the PICU. Family presence on rounds may have benefits that outweigh the additional time required to complete each patient interaction.
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