Family-Centered Rounds Checklist Implementation

Study Overview
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Brief Summary
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The goal of this study is to develop, implement, and evaluate the effectiveness of an intervention designed to facilitate family engagement during bedside rounds at a children's hospital. The intervention consists of a checklist of key behaviors associated with the delivery of quality family-centered rounds, as well as training in the use of the checklist tool. In a pre-post controlled design, two hospital services will be randomized to use the checklist while two others will be randomized to usual care. The intervention is expected to increase to the performance of key checklist behaviors, family engagement, and family perceptions of patient safety.

Detailed Description
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Family engagement in children's healthcare encounters has been suggested as a means to improve safety. To engage families in care, the recommended practice is to conduct rounds at the child's bedside with the family present (family-centered rounds). Family-centered rounds strive to engage families in (1) a relationship with care providers, (2) exchange of information for decision making, and (3) deliberation about decisions. Bedside rounds represent a consistent venue to engage families in the care of hospitalized children, yet no studies have systematically identified and examined the barriers and facilitators of family engagement during rounds as a means to improve safety.

Official Title
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Engaging Families in Bedside Rounds to Promote Pediatric Patient Safety

Conditions
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Child, Hospitalized, Delivery of Health Care, Morning Rounds

Intervention / Treatment
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* Other: Family-centered rounds checklist tool


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Admitted as an inpatient on the pediatric hospitalist service, pulmonary service, or hematology/oncology service, during the study period. Exclusion Criteria: Stigmatizing/sensitive reason for hospitalization (e.g., suspected non-accidental trauma or mental health concerns) New cancer diagnosis Parent(s) unable to speak or read English Parent(s) unavailable to consent (absent or sleeping during recruitment visits) Already participated in the study during a prior inpatient admission

Ages Eligible for Study
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Maximum Age: 17 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Family-centered rounds checklist<br>During the post-intervention period, health care team members on two pediatric inpatient services received the Family-centered Rounds Checklist tool, as well as training in how to use the checklist in the delivery of effective family-centered rounds | Other: Family-centered rounds checklist tool<br>* A printed checklist containing 9 key tasks associated with effective delivery of family-centered rounds. A previously-identified member of each rounding team was responsible for holding the printed checklist during morning rounds. Team members were trained the in the use of this checklist prior to the post-intervention period, and a brief refresher training was conducted mid-way through the period.<br>|
| No Intervention: Usual care<br>Two pediatric inpatient services were not provided the Family-centered rounds checklist tool, and delivered morning rounds in their usual manner. These services served as a control. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Parent perceptions of hospital safety climate | Children's Hospital Safety Climate survey | Change between baseline (inpatient admission) and study completion (discharge from hospital, an average of 6 days) | 
| Family engagement in rounds | Video data was collected for every morning round over the course of the patient's hospital stay. These videos were coded for measures of family engagement in rounds using established and validated coding systems (e.g. RIAS). | Every family-centered morning round that occurred during the patient's hospital stay through study completion, an average of 6 days | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Checklist item performance | Assessment of how many key checklist elements were performed during each family-centered round (coded from video recordings of each round). | Every family-centered morning round that occurred during the patient's hospital stay through study completion, an average of 6 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Morning Rounds, Patient-centered Care, Hospital Medicine, Pediatrics, Hospitals, Pediatric