Family rounds checklist study shows increased family engagement
UW Health News May 01, 2017
The simple practice of using a checklist can promote better care for hospitalized children, according to a study published in the journal Pediatrics.
Elements of a checklist used in family–centered rounds (FCR) increased family engagement and the safety of hospitalized children from the perspective of the families. The study, led by Dr. Elizabeth Cox, associate professor of pediatrics at the University of Wisconsin School of Medicine and Public Health, was conducted at UW HealthÂs American Family ChildrenÂs Hospital.
ÂThe study indicates that the checklist can effectively promote consistent delivery of high–quality, family–centered pediatric inpatient care, said Cox.
Her research team examined the impact of the FCR Checklist Intervention, developed with input from children's hospital staff and the families of hospitalized children, on performance of FCR elements, family engagement, and patient safety. The Intervention, championed by Dr. Michelle Kelly, a hospitalist and an assistant professor of pediatrics, consists of an eight–point checklist and provider training.
The checklist elements:
More than 650 videos were evaluated to see which elements of the checklist were performed and to gauge family engagement in tasks like building a relationship with the rounding team, giving and gathering information, and engaging in decision–making. The families also completed the ChildrenÂs Hospital Safety Climate Survey to get a picture of how parents view safety during the hospital stay.
Cox said the completion of checklist items increased significantly on the services using the FCR checklist, and two particular items significantly increased family engagement. She found that when the health–care team read back orders, families provided more information and engaged in more decision–making. Families also engaged more when the team talked about goals for discharge.
Cox said two checklist elements actually resulted in less family engagement: health care teams assessing childrenÂs progress and asking families for questions. Cox said one theory is that the assessment may have created reassurance or clarity for families who then felt less need to engage. Alternatively, because the study measured only whether the assessment was provided and not how well the assessment was done, it is possible that these assessments could be improved to be more engaging for families. Cox said even though providing assessment reduced family engagement, it should not necessarily be seen as a detriment to care.
Further, with regard to patient safety, specific elements of the checklist were associated with parents believing that their child was safer during the hospital stay. For example, parent perceptions of safety were greater when the team asked the family for questions. In addition, parents perception of the safety of handoffs and transitions were greater when the rounding team gave an assessment of childrenÂs progress.
Go to Original
Elements of a checklist used in family–centered rounds (FCR) increased family engagement and the safety of hospitalized children from the perspective of the families. The study, led by Dr. Elizabeth Cox, associate professor of pediatrics at the University of Wisconsin School of Medicine and Public Health, was conducted at UW HealthÂs American Family ChildrenÂs Hospital.
ÂThe study indicates that the checklist can effectively promote consistent delivery of high–quality, family–centered pediatric inpatient care, said Cox.
Her research team examined the impact of the FCR Checklist Intervention, developed with input from children's hospital staff and the families of hospitalized children, on performance of FCR elements, family engagement, and patient safety. The Intervention, championed by Dr. Michelle Kelly, a hospitalist and an assistant professor of pediatrics, consists of an eight–point checklist and provider training.
The checklist elements:
- ensure the nurse is present
- check family preference for rounds
- ask if the family knows everyone on the team
- discuss with the family the patient assessment and plan for the day
- review and update goals for discharge
- ask the family and the team for questions
- read back orders.
More than 650 videos were evaluated to see which elements of the checklist were performed and to gauge family engagement in tasks like building a relationship with the rounding team, giving and gathering information, and engaging in decision–making. The families also completed the ChildrenÂs Hospital Safety Climate Survey to get a picture of how parents view safety during the hospital stay.
Cox said the completion of checklist items increased significantly on the services using the FCR checklist, and two particular items significantly increased family engagement. She found that when the health–care team read back orders, families provided more information and engaged in more decision–making. Families also engaged more when the team talked about goals for discharge.
Cox said two checklist elements actually resulted in less family engagement: health care teams assessing childrenÂs progress and asking families for questions. Cox said one theory is that the assessment may have created reassurance or clarity for families who then felt less need to engage. Alternatively, because the study measured only whether the assessment was provided and not how well the assessment was done, it is possible that these assessments could be improved to be more engaging for families. Cox said even though providing assessment reduced family engagement, it should not necessarily be seen as a detriment to care.
Further, with regard to patient safety, specific elements of the checklist were associated with parents believing that their child was safer during the hospital stay. For example, parent perceptions of safety were greater when the team asked the family for questions. In addition, parents perception of the safety of handoffs and transitions were greater when the rounding team gave an assessment of childrenÂs progress.
Only Doctors with an M3 India account can read this article. Sign up for free or login with your existing account.
4 reasons why Doctors love M3 India
-
Exclusive Write-ups & Webinars by KOLs
-
Daily Quiz by specialty
-
Paid Market Research Surveys
-
Case discussions, News & Journals' summaries