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Virtual family-centered rounds: a quality improvement initiative to adapt inpatient care during COVID-19 using a
Melanie Buba1,2,3, Catherine Dulude4,5, Roisin O'Donnell4,6
1Department of Pediatrics, Division of Pediatric Medicine, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. mbuba@cheo.on.ca.
Insights
Virtual family-centered rounds (vFCR) provide a satisfactory alternative to in-person care during pandemics. This method supports physical distancing and preserves personal protective equipment (PPE), proving valuable for pediatric inpatient care.
Area of Science:
- Healthcare Management
- Pediatric Medicine
- Telehealth
Background:
- Family-centered rounds (FCR) are crucial for pediatric inpatient care.
- The COVID-19 pandemic necessitated adaptations to maintain FCR while adhering to physical distancing and personal protective equipment (PPE) guidelines.
Purpose of the Study:
- To design and implement a virtual family-centered rounds (vFCR) process.
- To evaluate the feasibility and acceptance of vFCR during the COVID-19 pandemic.
Main Methods:
- A multidisciplinary team utilized a participatory design approach to develop the vFCR process.
- Quality improvement methods were employed for iterative evaluation and enhancement from April to July 2020.
- Data on satisfaction, perceived effectiveness, and usefulness were collected via questionnaires from patients, families, and healthcare staff. Virtual auditors monitored round duration.
Main Results:
- High satisfaction rates were reported: 74% of healthcare providers and 79% of patients/families were satisfied or very satisfied.
- Perceived usefulness was high, with 88% of both healthcare providers and patients/families finding vFCR useful.
- Average duration for a single patient round was 8.4 minutes, with an average transition time of 2.9 minutes between patients.
Conclusions:
- Virtual family-centered rounds (vFCR) are an acceptable and effective alternative to in-person FCR, particularly in pandemic situations.
- vFCR demonstrate high stakeholder satisfaction and support, contributing to physical distancing and PPE preservation.
- The vFCR model holds potential value for inpatient care beyond pandemic scenarios, with ongoing process evaluations planned.
Background:
Family-centered rounds (FCR) are fundamental to pediatric inpatient care. During the COVID-19 pandemic, we aimed to design and implement a virtual family-centered rounds (vFCR) process that allowed continuation of inpatient rounds while following physical distancing guidelines and preserving personal protective equipment (PPE).
Methods:
A multidisciplinary team developed the vFCR process using a participatory design approach. From April through July 2020, quality improvement methods were used to iteratively evaluate and improve the process. Outcome measures included satisfaction, perceived effectiveness, and perceived usefulness of vFCR. Data were collected via questionnaire distributed to patients, families, staff and medical staff, and analyzed using descriptive statistics and content analysis. Virtual auditors monitored time per patient round and transition time between patients as balancing measures.
Results:
Seventy-four percent (51/69) of health care providers surveyed and 79% (26/33) of patients and families were satisfied or very satisfied with vFCR. Eighty eight percent (61/69) of health care providers and 88% (29/33) of patients and families felt vFCR were useful. Audits revealed an average vFCR duration of 8.4 min (SD = 3.9) for a single patient round and transition time between patients averaged 2.9 min (SD = 2.6).
Conclusion:
Virtual family-centered rounds are an acceptable alternative to in-person FCR in a pandemic scenario, yielding high levels of stakeholder satisfaction and support. We believe vFCR are a useful method to support inpatient rounds, physical distancing, and preservation of PPE that may also be valuable beyond the pandemic. A rigorous process evaluation of vFCR is underway.
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