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Initiative to increase family presence and participation in daily rounds on a paediatric acute care cardiology unit

Published online by Cambridge University Press:  04 May 2023

Dana B. Gal Open the ORCID record for Dana B. Gal [Opens in a new window] ,
Colleen M. Pater Open the ORCID record for Colleen M. Pater [Opens in a new window] ,
Mackenzie McGinty ,
Greta Lobes ,
Christy Tuemler ,
Paula M. Eldridge ,
Brittany Frakes ,
Elisa Marcuccio Open the ORCID record for Elisa Marcuccio [Opens in a new window] ,
Samuel P. Hanke  and
Michael G. Gaies
Dana B. Gal*
Affiliation:
Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, USA Division of Cardiology, Heart Institute, Children’s Hospital Los Angeles, Los Angeles, CA, USA
Colleen M. Pater
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
Mackenzie McGinty
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Greta Lobes
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Christy Tuemler
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Paula M. Eldridge
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Brittany Frakes
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Elisa Marcuccio
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
Samuel P. Hanke
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
Michael G. Gaies
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA
*
Corresponding author: Dr D. B. Gal, Department of Pediatrics, Keck School of Medicine, University of Southern California, 4650 Sunset Blvd. Los Angeles, CA 90027, USA. E-mail: dgal@chla.usc.edu
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Abstract

Introduction:

Family-centred rounds benefit families and clinicians and improve outcomes in general paediatrics, but are understudied in subspecialty settings. We sought to improve family presence and participation in rounds in a paediatric acute care cardiology unit.

Methods:

We created operational definitions for family presence, our process measure, and participation, our outcome measure, and gathered baseline data over 4 months of 2021. Our SMART aim was to increase mean family presence from 43 to 75% and mean family participation from 81 to 90% by 30 May, 2022. We tested interventions with iterative plan-do-study-act cycles between 6 January, 2022 and 20 May, 2022, including provider education, calling families not at bedside, and adjustment to rounding presentations. We visualised change over time relative to interventions with statistical control charts. We conducted a high census days subanalysis. Length of stay and time of transfer from the ICU served as balancing measures.

Results:

Mean presence increased from 43 to 83%, demonstrating special cause variation twice. Mean participation increased from 81 to 96%, demonstrating special cause variation once. Mean presence and participation were lower during high census (61 and 93% at project end) but improved with special cause variation. Length of stay and time of transfer remained stable.

Conclusions:

Through our interventions, family presence and participation in rounds improved without apparent unintended consequences. Family presence and participation may improve family and staff experience and outcomes; future research is warranted to evaluate this. Development of high level of reliability interventions may further improve family presence and participation, particularly on high census days.

Keywords

Family-centered roundingacute care cardiologyinpatient cardiologyquality improvement

Information

Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 1 , January 2024 , pp. 44 - 49
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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