Family-Centered Rounding: Can It Impact the Time of Discharge and Time of Completion of Studies at an Academic Children’s Hospital?

Abstract

Background and Objective: Family-centered rounds (FCR) involve multidisciplinary rounds at the patient bedside with an emphasis on physicians partnering with patients and families in the clinical decision-making for the patient. Although the purpose of FCR is to provide patient-centered care, an unanticipated benefit of FCR may be to improve time to discharge. The objective of this study was to determine the impact of FCR on time to discharge for pediatric patients in an academic medical center. Methods: We retrospectively compared the timing of patient discharges from July 2007 to June 2008 (before FCR) versus those from July 2008 to May 2009 (after FCR) on the pediatric hospital medicine service. We further compared time from order entry to study completion on a subset of patients receiving head MRIs and EEGs, studies that typically occurred on the day of discharge. Results: In our center, before FCR, 40% of patients were discharged before 3:00 pm (n = 912). After FCR, 47% of children were discharged before 3:00 pm (n = 911) (P = .0036). Time from order entry to study completion for MRIs and EEGs decreased from 2.15 hours before FCR (n = 225) to 1.73 hours after FCR (n = 206) (P = .001). Conclusions: FCR provided a modest improvement in the timeliness of the discharge process at our institution.