How you can make the most of family-centered medical rounds

FamilyCenteredRoundsOnce upon a time, not so very long ago, a child staying overnight in the hospital often stayed alone. You had fixed times you could visit, and a hospital stay was an isolating experience for child and parent.

However, we have learned that this does not create a good healing environment for our patients or their families. What we know now is that patient- and family-centered care typically improves medical outcomes.   Families not only help reduce the stress associated with hospitalization, they know their child better than any physician and that input is invaluable.

At TMC for Children, we’ve focused on family-centered care in the design of the rooms, the public spaces on the unit and through an on-going commitment of all of the care providers involved in your child’s care. Our recent partnership with pediatric hospitalists from Phoenix Children’s Hospital has only strengthened this approach with family-centered rounds.

What are family-centered rounds?

In the past, doctors would sit in the room and discuss the patients and the plan of care for the day.   This is what is known as “rounds.” We’ve learned over time that parents and other providers such as pharmacist and nurses are an important part of a child’s care team and they often have useful contributions on rounds. Thus, rounds in many pediatric units across the country have now migrated from the conference room to the patient room.

Now, every morning, a team of doctors, nurses, pharmacists, sometimes social workers and case managers, move from room to room on the pediatric unit to review with each family a child’s progress and discuss their plan of care for the day, according to Dr. Nancy Chen, one of our Phoenix Children’s pediatric hospitalists.

“Family-centered rounds are key to our care of our patients. Parents play as important of a role in the care team,” Dr. Chen said. “Both bring different strengths. Parents know their children and physicians know the appropriate evidence-based care for different diagnoses. Together, we can develop a plan of care that is in the best interest of both the family and the child.”

“Good communication is encouraged through family-centered rounds as they allow nurses, pharmacists, patients, parents and physicians to all discuss the current active issues and develop a plan for the day. It allows everyone to be on the same page and this overall, reduces errors or miscommunication.”

Parents share that this approach improves the relationship with the family and medical staff. If they, as parents, have a concern, it is easier for them to address it with the appropriate person and make their opinion known. Further, being included and having a structured avenue allows patients to build trust in the medical professionals.

What can parents do to capitalize on family-centered rounds?

  1. Be present on rounds

At TMC, rounds on the pediatric unit occur from 9 a.m. – noon every day. “We understand that this is a large time range,” Dr. Chen said, “but the order in which we round varies from day to day as acuity often changes. The best way to get your questions answered, talk to the doctors and hear the plan for the day is to be there when we come by.”

  1. Participate!

Listen on rounds, ask questions about things you don’t understand and don’t hesitate to speak up on rounds.

  1. Know that longer conversations may have to happen later

We want to spend time with all of our patients but we also need to see everybody by the end of the morning. For longer conversations, the provider may need to return to speak to you separately. Once the hospitalist sees all of the patients and develop plans to move everyone’s care forward, he or she can return in the afternoon to have more in-depth discussions.

  1. Write your questions down on a piece of paper

Oftentimes, you think of questions after the doctor leaves, or in the middle of the night. Write down the question on a piece of paper or on the whiteboard in the room.   We will be happy to answer them on rounds in the morning.

  1. Be part of shaping doctors of the future

The attending physician often is working with physicians in training and medical students. The attending physician will allow the trainees to present your child in a formal format and then may do some quick bedside teaching.   The teaching is for you as well! Please listen in and participate. This is how we all learn.   Don’t be surprised if you find that you have something to teach our trainees; our families often have valuable insight.

Just with every team, everybody brings different strengths. You, as a parent are a key team player on family-centered rounds.   Do not hesitate to ask questions and express your concerns.   Our goal is to provide high-quality, effective care for your child while in the hospital, and the best way we can do that is with your involvement.