Family-Centered Bedside Rounds: A New Approach to Patient Care and Teaching

Muething, Stephen E.; Kotagal, Uma R.; Schoettker, Pamela J.; Rey, Javier González del; DeWitt, Thomas G.

doi:10.1542/peds.2006-2528

Cited by 232 publications

(218 citation statements)

References 13 publications

(14 reference statements)

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“…In this way, having a clear understanding of membership can increase the likelihood that people with relevant knowledge will be included in discussions, a necessary first step to ensuring that those people have opportunities to speak up. As an example, there is evidence from the study of pediatric care that including patients' families and nurses-who are often excluded from physicians' rounds-provides meaningful benefits in the form of better diagnoses and care plan development because these individuals can contribute information not possessed by other team members that can be used in making care decisions [14,15].…”

Section: Expertise Usementioning

confidence: 99%

Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication

Mayo¹,

Woolley

2016

AMA Journal of Ethics

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Teams offer the potential to achieve more than any person could achieve working alone; yet, particularly in teams that span professional boundaries, it is critical to capitalize on the variety of knowledge, skills, and abilities available. This article reviews research from the field of organizational behavior to shed light on what makes for a collectively intelligent team. In doing so, we highlight the importance of moving beyond simply including smart people on a team to thinking about how those people can effectively coordinate and collaborate. In particular, we review the importance of two communication processes: ensuring that team members with relevant knowledge (1) speak up when one's expertise can be helpful and (2) influence the team's work so that the team does its collective best for the patient. The Promise and Challenge of Team-Based Cross-Disciplinary Collaboration in Health CareAcross health care, there is an increasing reliance on teams from a variety of specialties (e.g., nursing, physician specialties, physical therapy, social work) to care for patients. At the same time, medical error is estimated to be "the third most common cause of death in the US" [1], and teamwork failures (e.g., failures in communication) account for up to 70-80 percent of serious medical errors [2][3][4][5]. The shift to providing care in teams is well founded given the potential for improved performance that comes with teamwork [6], but, as demonstrated by these grave statistics, teamwork does not come without challenges. Consequently, there is a critical need for health care professionals, particularly those in leadership roles, to consider strategies for improving team-based approaches to providing quality patient care.Teams offer the promise to improve clinical care because they can aggregate, modify, combine, and apply a greater amount and variety of knowledge in order to make decisions, solve problems, generate ideas, and execute tasks more effectively and efficiently than any individual working alone [6]. Given this potential, a multidisciplinary team of health care professionals could ideally work together to determine diagnoses,

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Section: Expertise Usementioning

confidence: 99%

Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication

Mayo¹,

Woolley

2016

AMA Journal of Ethics

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“…13 A possible solution to address time-intensive care coordination needs for CMC include the formation of multidisciplinary teams that conduct family-centered rounds to allow all involved in the care of the complex child, including family, medical staff, and bedside nurses to be included in the decision-making. [17][18][19][20][21] Families are the pediatric patient's main source of support, and offer the health care team valuable information unique to their child which helps in decisionmaking and may positively affect health outcomes. 17 Through meticulous familycentered care coordination, the hospitalist may be able to spend more time at the bedside with the families and patients to make appropriate medical decisions regarding the care of the child.…”

Section: Discussionmentioning

confidence: 99%

Pediatric Hospitalists’ Perspectives on the Care of Children With Medical Complexity

Adame

Rocha

Louden

et al. 2011

Hospital Pediatrics

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OBJECTIVE: The aims of this study were to identify pediatric hospitalists' perceived views of (1) barriers to delivering care to children with medical complexity (CMC) and (2) their preferred model of inpatient health care delivery for CMC. SUBJECTS:American Academy of Pediatrics Section on Hospital Medicine (AAP-SOHM) Listserv subscribers. METHODS:We conducted a cross-sectional survey of subscribers of the AAP-SOHM Listserv using the survey instrument SurveyMonkey®. Our survey was coadministered with a survey on pediatric hospitalist career satisfaction. RESULTS:The most signifi cant barriers to delivering care to CMC were (1) time constraints (89%), (2) inadequate postdischarge resources (75%), and (3) lack of evidence-based guidelines (64%). Although most pediatric hospitalists in an inpatient service currently care for both CMC and non-CMC patients (91%), only 25% perceive this to be the optimal service model for CMC. The majority of hospitalists (56%) believe that CMC are better served by either an inpatient service dedicated to CMC (30%) or comanaged with an inpatient consult service for CMC (26%). CONCLUSIONS:Identifying the perceived barriers to delivering care to CMC can assist pediatric hospitalists to design studies determining if care delivery is affected by these barriers. Most hospitalists care for CMC on the same service as uncomplicated patients, yet over half perceive that a different model of care delivery would better serve the needs of CMC.

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“…FCRs improve discharge timeliness 3 and parental understanding of discharge goals. 2 Trainees in this study reported that FCRs reduce the length of stay because FCRs ''put everyone on the same page'' and often include case managers who help with discharge planning.…”

Section: Fcrs Quality and Outcomesmentioning

confidence: 99%

Pediatrics Residents' Perspectives on Family-Centered Rounds: A Qualitative Study at 2 Children's Hospitals

Mittal¹,

Krieger²,

Lee³

et al. 2013

Journal of Graduate Medical Education

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Background Many academic hospitals have incorporated family-centered rounds, yet little is known about pediatrics residents' perspectives on the educational impact of these rounds. Objective To identify pediatrics residents' knowledge, attitudes, and beliefs about family-centered rounds, including perceived benefits and barriers. Methods We conducted focus groups of residents exposed to family-centered rounds at 2 university-affiliated, freestanding children's hospitals. Focus group data were analyzed using grounded theory. Results A total of 24 residents participated in 4 focus groups. Residents reported that family-centered rounds enhance education by increasing patient encounters and improving physical exam skills, direct observation, real-time feedback, and attending role modeling; improve parent satisfaction, interpersonal and communication skills, and safety; and reduce length of stay. Physical constraints (large teams and small rooms), lack of uniform approaches to family-centered rounds, variable attending teaching styles, and specific conditions (child abuse, patients on isolation) were cited barriers. Conclusions Pediatrics residents report that well-conducted family-centered rounds improve their education and the quality of patient care, including parent satisfaction, communication with families, and patients' length of stay. Standardizing family-centered rounds and reducing attending variability in teaching style might further enhance residents' educational experiences.

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Family-Centered Bedside Rounds: A New Approach to Patient Care and Teaching

Cited by 232 publications

References 13 publications

Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication

Teamwork in Health Care: Maximizing Collective Intelligence via Inclusive Collaboration and Open Communication

Pediatric Hospitalists’ Perspectives on the Care of Children With Medical Complexity

Pediatrics Residents' Perspectives on Family-Centered Rounds: A Qualitative Study at 2 Children's Hospitals

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