Factors Associated With Parental Participation in Family-Centered Rounds

Abstract

OBJECTIVES: Although families positively perceive family-centered rounds (FCR), factors associated with engagement have been examined in few studies. Our objective for this study was to test the hypothesis that inviting the parent to speak and nurse presence are associated with parent engagement during FCR. METHODS: We conducted a cross-sectional study with English-speaking parents (N = 199) of inpatients on the pediatric hospital medicine service at an academic medical center. We used a standardized checklist to record outcomes of engagement (number of questions asked and participation occurrences), predictor variables (team invited parent to speak, nurse presence), and other encounter-related variables. Parents were surveyed to assess parent and child characteristics and experiences during FCR. We examined parent, child, and encounter characteristic associations with the above outcomes using bivariate analyses and (for those associated in bivariate analyses) Poisson regressions. RESULTS: Inviting the parent to speak was independently associated with the number of questions asked (incident rate ratio [IRR] 1.4; 95% confidence interval [CI] 1.1–1.7). Trusting the medical team was inversely associated with questions asked (IRR 0.8; 95% CI 0.6–0.97). Factors associated with total participation included invitation for the parent to speak (IRR 1.5; 95% CI 1.3–1.6), nurse presence (IRR 1.3; 95% CI 1.1–1.5), white race (IRR 1.2; 95% CI 1.1–1.4), clerkship student presentation (IRR 1.2; 95% CI 1.03–1.3), and parent inclusion in rounding arrangement (IRR 1.5; 95% CI 1.05–2). CONCLUSIONS: Parents present during FCR are more engaged when invited to speak. Nurse presence was associated with total parent participation. Future studies to inform interventions to optimize engagement are warranted.