Published online March 30, 2009
PEDIATRICS Vol. 123 No. 4 April 2009, pp. e603-e608 (doi:10.1542/peds.2008-2238)
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ARTICLE

Family-centered Multidisciplinary Rounds Enhance the Team Approach in Pediatrics

Paul Rosen, MD, MPH, MMMa,b, Elizabeth Stenger, MDc, Matthew Bochkoris, MDc, Michael J. Hannon, MAd and C. Kent Kwoh, MDd,e

Departments of a Pediatrics
d Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
b Division of Rheumatology
c Department of Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
e Division of Rheumatology, Veterans Administration Pittsburgh Healthcare System, Pittsburgh, Pennsylvania

OBJECTIVE. The objective of this study was to determine the impact of family-centered multidisciplinary rounds on an inpatient pediatric ward. We hoped to (1) gain a better understanding of the patient and family experience with family-centered multidisciplinary rounds, (2) measure hospital staff satisfaction with family-centered multidisciplinary rounds compared with conventional rounds, and (3) understand the time commitment for family-centered multidisciplinary rounds and conventional rounds.

METHODS. A quasi-experimental design was undertaken during a 2-week period. During the first week, the hospital staff conducted conventional rounds. Families were surveyed daily, and the staff were surveyed at the end of the week regarding their experiences. During the second week, newly admitted patients received family-centered multidisciplinary rounds at the bedside. Again, both families and staff were surveyed. Observers recorded the interactions between families and staff and measured the time required to conduct rounds.

RESULTS. A total of 27 patients were admitted during the 2-week study period. No significant differences were found in family satisfaction between conventional rounds and family-centered multidisciplinary rounds. A total of 53 surveys were collected from staff members. The staff reported better understanding of the patients' medical plans, better ability to help the families, and a greater sense of teamwork with family-centered multidisciplinary rounds compared with conventional rounds. It required an additional 2.7 minutes per patient during rounds for family-centered multidisciplinary rounds. With family-centered multidisciplinary rounds, the family affected the medical decision-making discussion in 90% of cases.

CONCLUSIONS. Family-centered multidisciplinary rounds is a method of conducting inpatient hospital rounds that fosters teamwork and empowers hospital staff. The patient and family are engaged in and are the focal point of the rounds. Staff members are able to hear everyone's perspective and give input. The impact on staff satisfaction and the family's ability to participate in their care is significant.

Key Words: family-centered • staff retention • bedside rounds

Abbreviations: FCMDR—family-centered multidisciplinary rounds • CR—conventional rounds • UPMC—University of Pittsburgh Medical Center

Accepted Jan 6, 2009.


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