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Caregiver and provider attitudes toward family-centred rounding in paediatric acute care cardiology

Published online by Cambridge University Press:  18 May 2023

Dana B. Gal*
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Keck School of Medicine, Los Angeles, CA, USA Children’s Hospital of Los Angeles, Los Angeles, CA, USA
Megan Rodts
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Brittney K. Hills
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA
Alaina K. Kipps
Affiliation:
Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA
Danton S. Char
Affiliation:
Stanford Center for Biomedical Ethics, Palo Alto, CA, USA Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
Colleen Pater
Affiliation:
The Heart Institute, Cincinnati Children’s Hospital, Cincinnati, OH, USA Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
Nicolas L. Madsen
Affiliation:
Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas. Texas, 75390, USA
*
Corresponding author: D. Gal, MD, E-mail: dgal@chla.usc.edu

Abstract

Family-centered rounding has emerged as the gold standard for inpatient paediatrics rounds due to its association with improved family and staff satisfaction and reduction of harmful errors. Little is known about family-centered rounding in subspecialty paediatric settings, including paediatric acute care cardiology.

In this qualitative, single centre study, we conducted semi-structured interviews with providers and caregivers eliciting their attitudes toward family-centered rounding. An a priori recruitment approach was used to optimise diversity in reflected opinions. A brief demographic survey was completed by participants. We completed thematic analysis of transcribed interviews using grounded theory.

In total, 38 interviews representing the views of 48 individuals (11 providers, 37 caregivers) were completed. Three themes emerged: rounds as a moment of mutual accountability, caregivers’ empathy for providers, and providers’ objections to family-centered rounding. Providers’ objections were further categorised into themes of assumptions about caregivers, caregiver choices during rounds, and risk for exacerbation of bias and inequity.

Caregivers and providers in the paediatric acute care cardiology setting echoed some previously described attitudes toward family-centered rounding. Many of the challenges surrounding family-centered rounding might be addressed through access to training for caregivers and providers alike. Hospitals should invest in systems to facilitate family-centered rounding if they choose to implement this model of care as the current state risks erosion of provider–caregiver relationship.

Type
Original Article
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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