Family-centered rounds in Pakistani pediatric intensive care settings: non-randomized pre- and post-study design.
BACKGROUND
Involvement of family in bedside rounds is one strategy to implement family-centered care to help families get clear information about their child, and be actively involved in decision-making about care. However in developing countries such as Pakistan, daily bedside rounds include the physician, residents, medical students and a nurse/technician. Parents are not currently a part of these rounds.


OBJECTIVE
To assess whether family-centered rounds improve parents' and health care professionals' satisfaction, decrease patient length of stay, and improve time utilization when compared to traditional practice rounds in a population with a low literacy rate, socioeconomic status, and different cultural values and beliefs.


METHODS
A non-randomized before-after study design.


METHODS
A private hospital in Karachi, Pakistan.


METHODS
A convenience sample of 82 parents, whose children were hospitalized for a minimum of 48h, and 25 health care professionals able to attend two consecutive rounds.


METHODS
During the before phase, traditional bedside rounds were practiced; and during after phase, family-centered rounds were practiced. Parents and health care professionals completed a questionnaire on the second day of rounds. An observational form facilitated data collection on length of stay and time utilization during.


RESULTS
Parents' ratings during the family-centered rounds were significantly higher for some parental satisfaction items: evidence of team work (p=0.007), use of simple language during the rounds (p=0.002), feeling of inclusion in discussion at rounds (p=0.03), decision making (p=0.01), and preference for family-centered rounds (p=<0.001). No significant differences were found in health care professionals' satisfaction between rounds. Patient length of stay was significantly reduced in the family-centered rounds group, while no significant difference was found in the duration of rounds. Family-centered rounds served as an opportunity for parents to correct/add to patient history or documentation.


CONCLUSIONS
Parents were satisfied with both forms of rounds; however, they appeared to have a greater preference for family-centered rounds than health care professionals. Family-centered rounds were a resource for Pakistani parents, enabling direct communication with the medical team without impacting on the time required to complete rounds. Family-centered rounds may improve quality of care such as decreasing length of stay or preventing critical incidents.
The Aga Khan University Hospital-Clinical Trials Unit, Karachi, Pakistan.
Laila Akbar
LA
Ladak
Shahirose Sadrudin
SS
Premji
Muhammad Muneer
MM
Amanullah
Anwarul
A
Haque
Khairulnissa
K
Ajani
Fahad Javaid
FJ
Siddiqui
D002648:Child; D005260:Female; D016304:Hospitals, Private / Q000458:organization & administration*; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007588:Job Satisfaction; D008297:Male; D010154:Pakistan; D010290:Parents / Q000523:psychology*; D010348:Patient Care Team; D017060:Patient Satisfaction; D011368:Professional-Family Relations