Family-centered rounds in theory and practice: An ethnographic case study

Anupama Subramony, Patricia A. Hametz, Dorene Balmer

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

Background Family-centered rounds (FCR) seek to incorporate principles of family-centered care - including clear and open information sharing, respect, participation and collaboration - into inpatient settings. Although potential models designed to translate these principles into everyday clinical practice have been reported, few studies explore how FCR practices align with principles of family-centered care. Methods We conducted an ethnographic study, observing over 200 hours of FCR on a general pediatrics inpatient service from January to August 2010 (185 distinct rounding events). To complement observation, we conducted interviews with 6 family members. Qualitative analysis entailed applying codes to data from observation and interviews and deriving themes using the principles of family-centered care as an interpretive lens. Results Four themes emerged that suggested incomplete alignment between FCR practices and principles of family-centered care. 1) FCR provided a forum for information sharing; nonetheless, medical jargon sometimes limited communication. 2) Medical teams approached families with practices intended to demonstrated respect, but contextual factors served to undermine this intent. 3) FCR gave family members the opportunity to participate in care but did not guarantee their involvement. 4) FCR were a starting point for collaboration around plan making, but did not guarantee that collaboration occurred. Conclusions Although FCR practices may set the stage for family-centered care, they do not necessarily ensure that the principles of family-centered care are upheld. Efforts to more effectively deliver FCR should consider physical, organizational, and cultural factors that influence both patient/family and medical team behavior.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalAcademic Pediatrics
Volume14
Issue number2
DOIs
StatePublished - 2014
Externally publishedYes

Keywords

  • bedside rounds
  • communication
  • family centered rounds
  • family-centered care
  • patient centered care

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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