• Amanda B Levin, Kiondra R Fisher, Krista D Cato, Adrian D Zurca, and Tessie W October.
• 1Department of Critical Care Medicine, Children's National Health System, Washington, DC. 2Department of Pediatrics, George Washington University School of Medicine, Washington, DC.
• Pediatr Crit Care Me. 2015 Nov 1; 16 (9): 801-7.

ObjectiveTo identify areas for improvement in family-centered rounds from both the family and provider perspectives.DesignProspective, cross-sectional mixed-methods study, including an objective measure (direct observation of family-centered rounds) and subjective measures (surveys of English-speaking families and providers) of family-centered rounds.SettingPICU in a single, tertiary children's hospital.SubjectsFamilies of children admitted to the PICU, physicians, and nurses.InterventionsNone.Measurements And Main ResultsTwo hundred thirty-two family-centered round encounters were observed over a 10-week period. Family-centered round encounters averaged 10.5 minutes per child. Multivariable regression analysis revealed that family presence was independently associated with length of family-centered rounds (p < 0.002) despite family talk time accounting for an average of 25 seconds (4%) of the encounter. Non-English-speaking families were less likely to attend family-centered rounds compared with English-speaking families even when physically present at the patient's bedside (p < 0.001). Most commonly families and providers agreed that family-centered rounds keep the family informed and reported positive statements about family presence on family-centered rounds; however, PICU fellows did not agree that families provided pertinent information and nurses reported that family presence limited patient discussions. The primary advice families offered providers to improve family-centered rounds was to be more considerate and courteous, including accommodating family schedules, minimizing distractions, and limiting computer viewing.ConclusionsFamily presence increased the length of family-centered rounds despite a small percentage of time spoken by families, suggesting longer rounds are due to changes in provider behavior when families are present. Also, non-English-speaking families may need more support to be able to attend and benefit from family-centered rounds. Lastly, in an era of full family-centered rounds acceptance, families and most providers, except fellows, report benefit from family presence during family-centered rounds. However, providers should be aware of the perception of their behaviors to optimize the experience for families.

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