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

Autor:	Gal DB; 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., Pater CM; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA., McGinty M; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Lobes G; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Tuemler C; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Eldridge PM; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Frakes B; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Marcuccio E; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA., Hanke SP; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA., Gaies MG; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, USA.
Jazyk:	angličtina
Zdroj:	Cardiology in the young [Cardiol Young] 2024 Jan; Vol. 34 (1), pp. 44-49. Date of Electronic Publication: 2023 May 04.
DOI:	10.1017/S1047951123001063
Abstrakt:	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.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu