Presentation
Investigating the Environmental Barriers and Facilitators to Family-centered Rounds (FCRs) in a Pediatric Intensive Care Unit (PICU)
DescriptionDue to the complexity of patient illnesses, family-centered interdisciplinary bedside rounds are pertinent in pediatric critical care settings (Gurses & Xiao, 2006; Lane et al., 2013). Family participation during rounds, also known as family-centered rounds (FCRs), is among the many evidence-based best practices for fostering engagement in pediatric settings where families play an integral role in decision-making and communication. FCRs in a pediatric intensive care unit (PICU) can improve shared decision-making and information exchange between families and team members (Sharma et al., 2022; Stickney et al., 2014; Tripathi et al., 2015).
Since FCRs are the only time when the entire interdisciplinary care team, patients (health permitting), and family members collaborate and formulate a patient care plan (Landry et al., 2007; Stickney et al., 2014; Tripathi et al., 2015), a supportive environment free of disruptions and interruptions could improve staff and family experience of FCRs manifolds. Studies show that design features like soothing colors, privacy, access to positive distractions, and family-oriented spaces like family zones within patient rooms, family lounges, and other support facilities in the PICU foster a supportive environment of care for families, thereby supporting family presence during rounds (Davidson et al., 2007).
FCRs are critical in supporting communication and collaboration between the team and the patient and families. However, there is very little information about the workflow of FCRs or how the physical environment supports FCRs. For example, some studies recommend standardizing the rounding process (Lane et al., 2013); however, there is not enough evidence if that is feasible. Therefore, this study examines the PICU environmental elements that facilitate or deter family participation and engagement by mapping space utilization, staff workflows, team configurations, and interruptions that impact communication and collaboration during FCRs.
This study utilizes a multiple-embedded case study design (Yin, 2013) to examine various work system elements contributing to the process of FCRs, including people, tasks, tools, and organizational factors interacting within the PICU built environment. This study contributes significantly to the understanding of dedicated family zones, hallway designs, location of decentralized nursing stations, patient and family privacy and visibility, patient room door design, and design of congregation areas that support communication and collaboration. In addition, the study also sheds light on the complexities of the FCR process using a systems approach and focusing on the types of interactions, rounding styles and preferences, tools used, the importance of line-of-sight, scheduling of FCRs, types and frequencies of interruptions to the process, and the workflows of staff members that conduct FCRs.
Since FCRs are the only time when the entire interdisciplinary care team, patients (health permitting), and family members collaborate and formulate a patient care plan (Landry et al., 2007; Stickney et al., 2014; Tripathi et al., 2015), a supportive environment free of disruptions and interruptions could improve staff and family experience of FCRs manifolds. Studies show that design features like soothing colors, privacy, access to positive distractions, and family-oriented spaces like family zones within patient rooms, family lounges, and other support facilities in the PICU foster a supportive environment of care for families, thereby supporting family presence during rounds (Davidson et al., 2007).
FCRs are critical in supporting communication and collaboration between the team and the patient and families. However, there is very little information about the workflow of FCRs or how the physical environment supports FCRs. For example, some studies recommend standardizing the rounding process (Lane et al., 2013); however, there is not enough evidence if that is feasible. Therefore, this study examines the PICU environmental elements that facilitate or deter family participation and engagement by mapping space utilization, staff workflows, team configurations, and interruptions that impact communication and collaboration during FCRs.
This study utilizes a multiple-embedded case study design (Yin, 2013) to examine various work system elements contributing to the process of FCRs, including people, tasks, tools, and organizational factors interacting within the PICU built environment. This study contributes significantly to the understanding of dedicated family zones, hallway designs, location of decentralized nursing stations, patient and family privacy and visibility, patient room door design, and design of congregation areas that support communication and collaboration. In addition, the study also sheds light on the complexities of the FCR process using a systems approach and focusing on the types of interactions, rounding styles and preferences, tools used, the importance of line-of-sight, scheduling of FCRs, types and frequencies of interruptions to the process, and the workflows of staff members that conduct FCRs.
Event Type
Oral Presentations
TimeWednesday, March 279:30am - 9:50am CDT
LocationSalon A-1
Hospital Environments