title: Family-initiated dialogue about medications during family-centered rounds.
abstract: OBJECTIVE
  Experts suggest family engagement in care can improve safety for hospitalized children. Family-centered rounds (FCRs) can offer families the opportunity to participate in error recovery related to children's medications. The objective of this study was to describe family-initiated dialogue about medications and health care team responses to this dialogue during FCR to understand the potential for FCR to foster safe medication use.
  
  
  METHODS
  FCR were video-recorded daily for 150 hospitalized children. Coders sorted family-initiated medication dialogue into mutually exclusive categories, reflecting place of administration, therapeutic class, topic, and health care team responses. Health care team responses were coded to reflect intent, actions taken by the team, and appropriateness of any changes.
  
  
  RESULTS
  Eighty-three (55%) of the 150 families raised 318 medication topics during 347 FCR. Most family-initiated dialogue focused on inpatient medications (65%), with home medications comprising 35%. Anti-infectives (31%), analgesics (14%), and corticosteroids (11%) were the most commonly discussed medications. The most common medication topics raised by families were scheduling (24%) and adverse drug reactions (11%). Although most health care team responses were provision of information (74%), appropriate changes to the child's medications occurred in response to 8% of family-initiated dialogue, with most changes preventing or addressing adverse drug reactions or scheduling issues.
  
  
  CONCLUSIONS
  Most families initiated dialogue regarding medications during FCRs, including both inpatient and home medications. They raised topics that altered treatment and were important for medication safety, adherence, and satisfaction. Study findings suggest specific medication topics that health care teams can anticipate addressing during FCR.
authors.affiliation: Departments of Pediatrics, and.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Benjamin
authors.affiliation: Departments of Pediatrics, and ecox@wisc.edu.
authors.forename: Elizabeth D
authors.initials: ED
authors.lastname: Cox
authors.affiliation: University of Wisconsin Hospital and Clinics, Madison, Wisconsin;
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Trapskin
authors.affiliation: Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin;
authors.forename: Victoria P
authors.initials: VP
authors.lastname: Rajamanickam
authors.affiliation: University of Wisconsin Hospital and Clinics, Madison, Wisconsin;
authors.forename: Roderick C
authors.initials: RC
authors.lastname: Jorgenson
authors.affiliation: University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin; and.
authors.forename: Holly L
authors.initials: HL
authors.lastname: Weber
authors.affiliation: University of Wisconsin-Madison School of Pharmacy, Madison, Wisconsin; and.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Pearson
authors.affiliation: Center for Quality and Productivity Improvement, Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Pascale
authors.initials: P
authors.lastname: Carayon
authors.affiliation: University of Wisconsin Hospital and Clinics, Madison, Wisconsin;
authors.forename: Nikki L
authors.initials: NL
authors.lastname: Lubcke
mesh_terms: D000328:Adult; D002648:Child; D002675:Child, Preschool; D003142:Communication; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000517:prevention & control*; D010348:Patient Care Team; D011368:Professional-Family Relations
keywords: adverse drug reactions; family; medication errors; patient safety; physician-patient/parent communication