Related Experiment Video
Updated: Feb 1, 2026
The Participant-Reported Implementation Update and Score PRIUS: A Novel Method for Capturing Implementation-Related Data Over Time
Published on: February 19, 2021
Patient safety after implementation of a coproduced family centered communication programme: multicenter before and
Alisa Khan1,2, Nancy D Spector3,4, Jennifer D Baird5
1Harvard Medical School, Boston, MA, USA.
Insights
Implementing family-centered rounds improved patient safety by reducing harmful medical errors. This structured communication intervention also enhanced family experience and engagement during pediatric care.
Area of Science:
- Pediatric healthcare quality improvement
- Patient safety research
- Communication in healthcare
Background:
- Standardizing communication during pediatric inpatient rounds is crucial for patient safety and family experience.
- Previous approaches lacked structured, reliable communication protocols between healthcare providers and families.
Purpose of the Study:
- To evaluate the impact of a standardized communication intervention on medical errors, family experience, and communication processes during family-centered rounds.
- To assess changes in harmful errors, non-harmful errors, and family-reported outcomes post-intervention.
Main Methods:
- A prospective, multicenter before-and-after study was conducted in pediatric inpatient units across seven North American hospitals.
- The intervention involved coproduced, structured communication protocols, real-time summaries, provider training, and teamwork strategies.
- Medical errors were measured using systematic surveillance, including family safety reporting; family experience and communication processes were also assessed.
Main Results:
- Harmful medical errors (preventable adverse events) decreased by 37.9% (P=0.01), and non-preventable adverse events decreased by 58.0% (P=0.003).
- Overall medical error rates remained unchanged (P=0.21).
- Family-reported experience improved in several areas, and family engagement (P=0.04) and nurse engagement (P=0.03) on rounds increased.
Conclusions:
- A structured communication intervention for family-centered rounds, coproduced by families, nurses, and physicians, significantly reduced harmful medical errors.
- The intervention improved family experience and communication processes without negatively impacting trainee teaching or round duration.
- Family-centered care processes show promise for enhancing patient safety and quality in pediatric settings.
Objective:
To determine whether medical errors, family experience, and communication processes improved after implementation of an intervention to standardize the structure of healthcare provider-family communication on family centered rounds.
Design:
Prospective, multicenter before and after intervention study.
Setting:
Pediatric inpatient units in seven North American hospitals, 17 December 2014 to 3 January 2017.
Participants:
All patients admitted to study units (3106 admissions, 13171 patient days); 2148 parents or caregivers, 435 nurses, 203 medical students, and 586 residents.
Intervention:
Families, nurses, and physicians coproduced an intervention to standardize healthcare provider-family communication on ward rounds ("family centered rounds"), which included structured, high reliability communication on bedside rounds emphasizing health literacy, family engagement, and bidirectional communication; structured, written real-time summaries of rounds; a formal training programme for healthcare providers; and strategies to support teamwork, implementation, and process improvement.
Main Outcome Measures:
Medical errors (primary outcome), including harmful errors (preventable adverse events) and non-harmful errors, modeled using Poisson regression and generalized estimating equations clustered by site; family experience; and communication processes (eg, family engagement on rounds). Errors were measured via an established systematic surveillance methodology including family safety reporting.
Results:
The overall rate of medical errors (per 1000 patient days) was unchanged (41.2 (95% confidence interval 31.2 to 54.5) pre-intervention v 35.8 (26.9 to 47.7) post-intervention, P=0.21), but harmful errors (preventable adverse events) decreased by 37.9% (20.7 (15.3 to 28.1) v 12.9 (8.9 to 18.6), P=0.01) post-intervention. Non-preventable adverse events also decreased (12.6 (8.9 to 17.9) v 5.2 (3.1 to 8.8), P=0.003). Top box (eg, "excellent") ratings for six of 25 components of family reported experience improved; none worsened. Family centered rounds occurred more frequently (72.2% (53.5% to 85.4%) v 82.8% (64.9% to 92.6%), P=0.02). Family engagement 55.6% (32.9% to 76.2%) v 66.7% (43.0% to 84.1%), P=0.04) and nurse engagement (20.4% (7.0% to 46.6%) v 35.5% (17.0% to 59.6%), P=0.03) on rounds improved. Families expressing concerns at the start of rounds (18.2% (5.6% to 45.3%) v 37.7% (17.6% to 63.3%), P=0.03) and reading back plans (4.7% (0.7% to 25.2%) v 26.5% (12.7% to 7.3%), P=0.02) increased. Trainee teaching and the duration of rounds did not change significantly.
Conclusions:
Although overall errors were unchanged, harmful medical errors decreased and family experience and communication processes improved after implementation of a structured communication intervention for family centered rounds coproduced by families, nurses, and physicians. Family centered care processes may improve safety and quality of care without negatively impacting teaching or duration of rounds.
Trial Registration:
ClinicalTrials.gov NCT02320175.
More Related Videos
Related Concept Videos
01:13Patient-centered Care
01:03Communication
01:57Gene Families
Occasionally these regions can be adapted to take on new roles within the organism, becoming novel genes...
01:57Gene Families
01:25Role of Communication in the Nursing Process II: Planning and Implementation
02:47Protein Families