title: Parent Participation in Pediatric Intensive Care Unit Rounds via Telemedicine: Feasibility and Impact.
abstract: To evaluate feasibility and impact of telemedicine for remote parent participation in pediatric intensive care unit (PICU) rounds when parents are unable to be present at their child's bedside.
  
  
  
  Parents of patients admitted to a 14-bed PICU were approached, and those unable to attend rounds were eligible subjects. Nurse and physician caregivers were also surveyed. Parents received an iPad (Apple Inc, Cupertino, California) with an application enabling audio-video connectivity with the care team. At a predetermined time for bedside rounds with the PICU team, parents entered a virtual meeting room to participate. Following each telemedicine encounter, participants (parent, physician, nurse) completed a brief survey rating satisfaction (0?=?not satisfied, 10?=?completely satisfied) and disruption (0?=?no disruption at all, 10?=?very disruptive).
  
  
  
  A total of 153 surveys were completed following 51 telemedicine encounters involving 13 patients. Parents of enrolled patients cited work demands (62%), care for other dependents (46%), and transportation difficulties (31%) as reasons for study participation. The median levels of satisfaction and disruption were 10 (range 5-10) and 0 (range 0-5), respectively. All parents reported that telemedicine encounters had a positive effect on their level of reassurance regarding their child's care and improved communication with the care team.
  
  
  
  This proof-of-concept study indicates that remote parent participation in PICU rounds is feasible, enhances parent-provider communication, and offers parents reassurance. Providers reported a high level of satisfaction with minimal disruption. Technological advancements to streamline teleconferencing workflow are needed to ensure program sustainability.
authors.affiliation: Department of Pediatrics, Division of Pediatric Critical Care, Massachusetts General Hospital, Boston, MA.
authors.forename: Phoebe H
authors.initials: PH
authors.lastname: Yager
authors.affiliation: Department of Pediatrics, Division of Pediatric Critical Care, Massachusetts General Hospital, Boston, MA.
authors.forename: Maureen
authors.initials: M
authors.lastname: Clark
authors.affiliation: Department of Pediatrics, Division of Pediatric Critical Care, Massachusetts General Hospital, Boston, MA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Cummings
authors.affiliation: Department of Pediatrics, Division of Pediatric Critical Care, Massachusetts General Hospital, Boston, MA.
authors.forename: Natan
authors.initials: N
authors.lastname: Noviski
mesh_terms: D000293:Adolescent; D001900:Boston; D002648:Child; D002675:Child, Preschool; D003142:Communication; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008297:Male; D010290:Parents; D010348:Patient Care Team; D017060:Patient Satisfaction; D010865:Pilot Projects; D011368:Professional-Family Relations; D011446:Prospective Studies; D056164:Teaching Rounds; D017216:Telemedicine; D049269:Videoconferencing; D055815:Young Adult
keywords: communication; family-centered care; telemedicine