Program Evaluation: Family Centered Rounding to Support Communication in Pediatric Care

Background: Family centered rounding (FCR) is a pediatric evidence-based practice intended to bring healthcare teams, patients, and families together at the bedside in a collaborative approach to care planning. FCR emphasizes communication and shared decision-making between healthcare teams and families, leading to improved patient outcomes. Despite well-documented benefits of FCR, challenges such as inconsistent nursing participation, variability in practices, and workflow disruptions hinder implementation and sustainability of FCR. Aim: This program evaluation was designed and conducted at an urban pediatric hospital to assess the processes, perceptions, and impact of FCR. The overall quality of FCR and the strengths and barriers to FCR practices were also assessed. Methods: Guided by the Center for Disease Control and Prevention’s Program Evaluation Framework, stakeholders were identified, followed by structured interviews and FCR observations. An interview and observation template was created based on critical rounding elements described in current literature. Evaluation outcomes included the identification and thematization of perceived barriers and strategies to enhance FCR. Outcomes: 81 rounding interactions were observed with 12 hospitalists. During the observation period, FCR occurred infrequently, with only 18% of patients. 12 hospitalists and 43 registered nurses (RNs) participated in interviews. Themes from hospitalists' perspectives included inconsistent FCR protocols based on patient acuity and RN availability. Themes from RNs included concerns about receiving adequate notice to coordinate for and participate in FCR. Both hospitalists and RNs identified benefits to FCR, which included improved communication, patient/family participation, and teamwork. Recommendations for improving FCR included clinician education regarding elements of FCR, addressing workflow issues such as RN coverage, and improving interdisciplinary attendance/participation in FCR. Impact: FCR enhances communication and strengthens collaboration between healthcare teams and families, thus improving patient outcomes, making it an important part of patient-and family-centered care. Summary: Family centered rounding (FCR) is a key practice in pediatric care that fosters collaboration, shared decision-making, and improved outcomes. Despite its benefits, challenges such as inconsistent nursing participation, workflow disruptions, and practice variability hinder effectiveness. A program evaluation at an urban pediatric hospital assessed FCR, revealing barriers and facilitators. Findings highlight the need for standardized protocols, improved interdisciplinary participation, and operational adjustments to enhance FCR.