Implementing Family-Centered Rounds in Hospital Pediatric Settings: A Scoping Review

Abstract

CONTEXT The American Academy of Pediatrics and Institute for Patient and Family-Centered Care issued a joint policy statement in 2012 recommending family and nurse participation in rounds as a standard practice. OBJECTIVE To synthesize available evidence on the state of the implementation of family-centered rounds (FCRs), including identified barriers to stakeholder acceptance and participation in FCRs in pediatric inpatient settings and implementation strategies to increase adherence and related outcomes. DATA SOURCES PubMed and Medline and the Cochrane Database of Systematic Reviews. STUDY SELECTION Observational and experimental studies from January 2009 to July 2020. DATA EXTRACTON Two reviewers independently screened each study to determine eligibility and extract data. Initial evidence quality was evaluated on the basis of study design. RESULTS A total of 53 studies were included in the final synthesis. FCRs are increasingly accepted by stakeholders, although participation lags. Structural barriers to nurse and family attendance persist. Limited high-quality evidence exists regarding the effectiveness of FCRs and related implementation strategies in improving patient outcomes. The lack of a clear, consistent definition of the elements that combine for a successful FCR encounter remains a significant barrier to measuring its effect. CONCLUSIONS Standardized research methods for improving the quality and comparability of FCR studies are needed to enhance the existing guidelines for FCR use. Structural changes in care delivery may be required to ensure the rounding process remains amenable to the needs of patients and their families.