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Hospital Rounds Get a Face-Lift
Many hospitals these days are trying to get away from the conventional “provider-oriented” variety of rounds, in which doctors and residents check in on a patient and then discuss his or her case among themselves. The newer version, referred to as “family-centered” rounds (FCRs), aims to keep a patient and his or her family in the loop, so that everyone may be involved in healthcare decisions. In a pediatric setting, FCR seems to have particular benefits, since parents want to be as involved as possible in medical decisions concerning their children.
Vineeta S. Mittal and her team at University of Texas Southwestern Medical Center at Dallas wanted to determine how this new version of hospital rounds faired overall, as well as the numbers and types of hospitals that were participating in family-centered rounds. The researchers found that of the 265 doctors surveyed, 44% said that they used family-centered rounds, and the remaining doctors said they used the traditional method. An interesting and perhaps not unexpected finding was that hospitals affiliated with universities were more likely than others to use FCRs – 48% vs. 31%, respectively.
The study also found that family-centered rounds did not take any longer than traditional rounds, which may alleviate any concerns that switching to the newer method would be less efficient than sticking with the traditional one. Academic hospitals also tended to have longer rounds, however, regardless of the type.
Why did hospitals choose not to use FCRs? The authors write that a central concern and a “crucial FCR barrier is trainees' fear of not appearing knowledgeable in front of the family” – though this is an understandable concern for a young doctor-in-training, it’s one that should perhaps be addressed and worked through, given the important benefits that FCR can offer.
Another hesitation that hospitals reported was the size of the patient’s room being unable to accommodate the medical team comfortably. And finally, “workflow and patient confidentiality” were also cited as reasons not to make the switch, but the authors note that these two issues are very possible to get around if a family-centered round is executed well.
The authors conclude by making a nice point about FCR’s potential impact on the quality of patient care: “[b]ecause hospitals are under increasing scrutiny in providing high-quality patient care and reporting performance measures, conducting FCRs may represent a powerful means of improving the quality of inpatient care.”
The study was published in the July 1, 2010 issue of the journal Pediatrics.
July 16, 2010
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