Family-Centered Rounds Checklist Implementation

Sponsor

University of Wisconsin, Madison (Other)

Overall Status

Completed

CT.gov ID

NCT02625142

Collaborator

Agency for Healthcare Research and Quality (AHRQ) (U.S. Fed)

340

Enrollment

Location

Arms

37.9

Duration (Months)

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

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.

Condition or Disease	Intervention/Treatment	Phase
Child, Hospitalized Delivery of Health Care Morning Rounds	Other: Family-centered rounds checklist tool	N/A

Detailed Description

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.

Study Design

Study Type:

Interventional

Actual Enrollment :

340 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Masking:

Single (Participant)

Primary Purpose:

Health Services Research

Official Title:

Engaging Families in Bedside Rounds to Promote Pediatric Patient Safety

Study Start Date :

Feb 1, 2010

Actual Primary Completion Date :

Apr 1, 2013

Actual Study Completion Date :

Apr 1, 2013

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Family-centered rounds checklist 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 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.
No Intervention: Usual care 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.

Arm

Intervention/Treatment

Experimental: Family-centered rounds checklist

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

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.

No Intervention: Usual care

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.

Outcome Measures

Primary Outcome Measures

Parent perceptions of hospital safety climate [Change between baseline (inpatient admission) and study completion (discharge from hospital, an average of 6 days)]
Children's Hospital Safety Climate survey
Family engagement in rounds [Every family-centered morning round that occurred during the patient's hospital stay through study completion, an average of 6 days]
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).

Secondary Outcome Measures

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

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A to 17 Years

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Yes

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