| Autor: |
Gal DB; 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., Rodts M; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Hills BK; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA., Kipps AK; Division of Pediatric Cardiology, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, California, USA., Char DS; 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., Pater C; The Heart Institute, Cincinnati Children's Hospital, Cincinnati, OH, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Madsen NL; Department of Pediatrics, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas. Texas, 75390, USA. |
| Abstrakt: |
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. |
