Impact of a Real-Time Virtual Rounding Queue on Neonatal Intensive Care Unit Rounding Practices: Survey Study of...

While family-centered rounds are considered the standard of care, coordinating the presence of all stakeholders without knowing when the medical team will arrive can make their implementation challenging. To address this barrier, we created novel software, Q-rounds, that is integrated into the electronic health record and creates a real-time rounding queue that updates nurses and family members on medical team rounding time and allows families to join in person or remotely via phone. A previous observational study showed that the implementation of Q-rounds in a neonatal intensive care unit (NICU) led to increased nurse and family presence.

This study aimed to understand clinicians' perceptions of the use of Q-rounds on NICU rounding practices, such as the impact on rounding efficiency and clinician satisfaction, as well as facilitators and barriers in its implementation.

Q-rounds was implemented in the NICU at M Health Fairview Masonic Children's Hospital in May 2023. In this survey study, surveys were distributed to physicians, advanced practice providers, and nurses 6 weeks before implementation and 6 weeks afterward to collect data on the impact of Q-rounds on family-centered rounds. Data were analyzed both quantitatively and qualitatively.

There were 118 respondents in the preimplementation phase and 110 in the postimplementation phase. After implementation of Q-rounds, clinicians perceived an increase in nurse presence ("most" or "almost all of the time" n/N= 48/105, 46% to n/N=24/36, 75%; P<.001) and family presence (at least "sometimes" n/N=45/106, 46% to n/N=35/36, 97%; P<.001) on rounds. Respondents perceived rounds as more efficient (n/N=56/105, 53% to n/N=27/36, 75%; P=.006), and more respondents indicated being satisfied with rounds (n/N=59/105, 46% to n/N=62/84, 74%; P=.003). There was no perceived difference in rounding duration. These findings were supported by thematic analysis of open-ended responses.

A novel virtual rounding queue software that notifies families and nurses of when to expect the rounding team was associated with increased clinician perceptions of efficiency, participation in rounds by nurses and families, and satisfaction with rounds.