title: Family participation during intensive care unit rounds: goals and expectations of parents and health care providers in a tertiary pediatric intensive care unit.
abstract: OBJECTIVE
  To compare perceptions, goals, and expectations of health care providers and parents regarding parental participation in morning rounds and target specific areas of opportunity for educational interventions.
  
  
  METHODS
  Semistructured interviews of parents and focus groups of health care providers to learn about their experiences in, goals for, and perceived barriers to successful parental participation in morning rounds. Qualitative methods were used to analyze interview and focus group transcripts.
  
  
  RESULTS
  Parents (n = 21) and health care providers (n = 24) participated in interviews and focus groups, respectively. Analyses revealed key areas of agreement between providers and parents regarding goals for rounds when parents are present, including helping parents achieve an understanding of the child's current status and plan of care. Providers and parents disagreed, however, about the nature of opportunities to ask questions. Parents additionally reported a strong desire to provide expert advice about their children and expected transparency from their care team, while providers stated that parental presence sometimes hindered frank discussions and education.
  
  
  CONCLUSIONS
  Some agreement in goals for parent participation in morning rounds exists, although there are opportunities to calibrate expectations for both parents and health care providers. Solutions may involve a protocol for orienting parents to morning rounds, focusing on improving communication with parents outside of morning rounds, and the preservation of a forum for providers to have private discussions as a team.
authors.affiliation: Division of Medicine Critical Care, Department of Medicine, Boston Children's Hospital, Boston, MA. Electronic address: carolyn.stickney@childrens.harvard.edu.
authors.forename: Carolyn A
authors.initials: CA
authors.lastname: Stickney
authors.affiliation: Division of Adolescent Medicine and Center for Patient Safety and Quality Research in the Program for Patient Safety and Quality, Boston Children's Hospital, Boston, MA; Department of Pediatrics, Harvard Medical School, Boston, MA.
authors.forename: Sonja I
authors.initials: SI
authors.lastname: Ziniel
authors.affiliation: Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, Boston, MA.
authors.forename: Molly S
authors.initials: MS
authors.lastname: Brett
authors.affiliation: Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, Boston, MA; Division of Medical Ethics, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA.
authors.forename: Robert D
authors.initials: RD
authors.lastname: Truog
mesh_terms: D000328:Adult; D001290:Attitude; D001291:Attitude of Health Personnel; D003256:Community Participation; D006801:Humans; D015278:Intensive Care Units, Pediatric / Q000458:organization & administration* / Q000600:supply & distribution*; D009937:Organizational Objectives; D016134:Organizational Policy; D010290:Parents; D010353:Patient Education as Topic; D056164:Teaching Rounds / Q000458:organization & administration*; D062606:Tertiary Care Centers; D014789:Visitors to Patients