Panel participants include:
- Dr. Angelo P. Giardino, Chief Medical Officer, Intermountain Primary Children’s Hospital and Chair, Department of Pediatrics, University of Utah School of Medicine
- Dr. Tiffany Glasgow, Chief, Division of Pediatric Hospital Medicine, University of Utah School of Medicine and Pediatric Hospitalist, Intermountain Primary Children's Hospital
- Stacy Allen, a parent of a child who has received care at Intermountain Primary Children's Hospital
Download the brochure for parents, Be a Part of DAILY ROUNDS at Primary Children’s Hospital.
Stacy Allen: My name is Stacy Allen and we are here to talk to you about family-centered rounding.
So I am a mother of a 10-year-old son with cystic fibrosis who's seen here at Primary Children's and in years past when Evan's been inpatient, it's always struck us as a little odd sometimes when we can see the team rounding outside the room, right. So we're like, “What's happening out there and why are we not part of the discussion?”
So I always like to think of family-centered rounding, like being in the room where it happened. And what I mean by that last year we took Evan to see Hamilton and since then he's been obsessed with the music. Have you guys seen it? (The others nod.)
And he loves the song, “The room where it happened.” And in that song, it talks about how Aaron Burr wishes that he was in the room with Hamilton when important decisions were being made, right? About our history. And just like that song, I feel like it's equally important that families are in the room when the rounding happens so that we can be part of those important discussions about our kids. How do you guys feel about that?
Dr. Tiffany Glasgow: Oh, I agree wholeheartedly. I can't imagine us making a decision without the biggest stakeholders right there with us. I so enjoy and embrace family-centered rounds.
So in that process we engage families, caregivers and nurses who are all such important members of the team and it always adds value to the conversation.
So whether that's information we didn't already know going into rounds, such as just today as I was rounding with my team, my residents said, “Oh, this is a four-year-old child with asthma.”
And the parent piped in and said, “Wait, actually my daughter doesn't have asthma.” That was really helpful.
And then really my favorite is when we don't always know what's going on or we're not clear about the plan and we can have that discussion in the room. The parent, family and bedside nurse become part of our investigative team. And they're really important eyes on that process.
Stacy Allen: That kind of bringing all the voices together in the room that matters so we get a clear picture of what's happening.
Dr. Tiffany Glasgow: And I love that Aaron Burr song. I have it in my head now.
Stacy Allen: Yeah, I know.
Dr. Angelo Giardino: Well, I love this idea of being in the room because family-centered rounds is such a part of the pediatric healthcare setting for a number of reasons.
One, pediatricians love to talk to the families and understand their point, as you were saying.
But it really is fundamentally part of the patient's safety journey as well, because as you were saying, the family really does know a lot about the child that we're talking about. And there's been really good research, some of which came from here in Intermountain Primary Children's Hospital, where if you do family-centered rounds the way you're talking about, where you're not outside the room but you're actually in the room talking to the child and the family, you can reduce preventable adverse events by 37%. * So think about that. Every 100 errors that we're talking about, 37 of them could be prevented. So family-centered rounds is a fundamental part of a patient safety journey.
I'll always remember I was at a conference once and we were talking about family-centered rounds and a parent that was at the table—you know, we have these little discussion groups. She said to me, “You know, you may think you know what I'm going to say, but you don't know what I'm going to say until I say it. And if it involves my child, you should hear what I have to say.” And that had a dramatic impression on me.
I think it's really fundamentally part of our value system that the families are a necessary team member for us to come up with a treatment plan. And it's such an affirming feeling after you interact with the families and understand they got to say what they needed to say and we heard what they said.
And then at a very granular level, if the medication is always a white tablet and a pink tablet shows up, it's so important for us to hear that because it may be that now the tablet's pink and that's OK, we can confirm that. But what if it was supposed to be the white one and the pink one came up? We need to stop that. We don't want the child to get the wrong tablet.
So family-centered rounds are really part and parcel of a safe environment. It's part of a respectful environment and it's really part of our value system. So I'm just delighted that you've experienced that. Stacy Allen: Yeah, I just love it so much and I think it's so important, like you said. I mean, just getting everybody on the same page and making sure that everybody comes together really is going to provide the best care for all the children that we see here.
Dr. Angelo Giardino: And we're all in the room.
Stacy Allen: Where it happens.
* Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. BMJ 2018;363:k4764. Alisa Khan, Nancy D Spector, Jennifer D Baird, Michele Ashland, Amy J Starmer, Glenn Rosenbluth,Briana M Garcia, Katherine P Litterer, Jayne E Rogers, Anuj K Dalal, Stuart Lipsitz, Catherine S Yoon, Katherine R Zigmont, Amy Guiot, Jennifer K O’Toole, Aarti Patel, Zia Bismilla, Maitreya Coffey, Kate Langrish, Rebecca L Blankenburg, Lauren A Destino, Jennifer L Everhart, Brian P Good, Irene Kocolas, Rajendu Srivastava, Sharon Calaman, Sharon Cray, Nicholas Kuzma, Kheyandra Lewis, E Douglas Thompson, Jennifer H Hepps, Joseph O Lopreiato, Clifton E Yu, Helen Haskell, Elizabeth Kruvand, Dale A Micalizzi, Wilma Alvarado-Little, Benard P Dreyer, H Shonna Yin, Anupama Subramony, Shilpa J Patel, Theodore C Sectish, Daniel C West, Christopher P Landrigan, on behalf of the Patient and Family Centered I-PASS Study Group