Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit: A Randomized Controlled Pilot Trial

Rosenthal, Jennifer L.; Sauers‐Ford, Hadley S.; Williams, J. Powell; Ranu, Jaskiran; Tancredi, Daniel J.; Hoffman, Kristin

doi:10.1016/j.acap.2021.03.007

Cited by 18 publications

(26 citation statements)

References 32 publications

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“…However, important differences exist between family members in the adult ICU compared with the PICU or neonatal ICU context, including family participant age, relationship, and role. Family members are much older in the adult ICU; the mean age of family member participants was 30 years old in one neonatal ICU study (32) compared with 52 years old in an adult ICU study (33). In the neonatal/PICU, family are almost exclusively parents or surrogates, whereas in the adult ICU, the most prevalent relationships are adult child, spouses/partners, and siblings (32, 33).…”

Section: Discussionmentioning

confidence: 99%

“…Family members are much older in the adult ICU; the mean age of family member participants was 30 years old in one neonatal ICU study (32) compared with 52 years old in an adult ICU study (33). In the neonatal/PICU, family are almost exclusively parents or surrogates, whereas in the adult ICU, the most prevalent relationships are adult child, spouses/partners, and siblings (32, 33). In addition, the family role also differs considerably between the settings (i.e., breastfeeding/lactation vs support during procedures, delirium reorientation).…”

Section: Discussionmentioning

confidence: 99%

“…We did not identify any studies that explored virtual family presence in adult ICU rounds using videoconferencing technology. In the neonatal ICU/PICU setting, videoconferencing was found to be a feasible solution to conduct multidisciplinary rounds, and participants found it effective without interfering with normal workflow (32). There is a great need for studies to be conducted in the adult ICU setting exploring the role of virtual family presence on ICU rounds.…”

Section: Discussionmentioning

confidence: 99%

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Family Presence on Rounds in Adult Critical Care: A Scoping Review

Calderone

Debay

Goldfarb

2022

Critical Care Explorations

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OBJECTIVES: Family presence on rounds involves allowing family members to participate in daily healthcare team rounds and is recommended by critical care professional societies. Yet, family presence on rounds is not performed in many institutions. There is a need to synthesize the current evidence base for this practice to inform healthcare providers of the potential benefits and challenges of this approach. The main objective of this study was to explore the impact of family presence on adult ICU rounds on family and healthcare providers.DATA SOURCES: Ovid Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and PubMed databases were last searched on January 28, 2022. Studies published during the COVID-19 pandemic were included. STUDY SELECTION:Studies involving family presence during rounds that included family or healthcare provider perspectives or outcomes were selected. There were no limitations on study design. DATA EXTRACTION:Qualitative and quantitative family and provider perspectives, barriers and challenges to family presence, and study outcomes were extracted from studies. The JBI Manual for Evidence Synthesis published guidelines were followed.DATA SYNTHESIS: There were 16 studies included. Family reported family presence on rounds as a means of information transfer and an opportunity to ask care-related questions. Family presence on rounds was associated with increased family satisfaction with care, physician comfort, and improved physician-family relationship. Healthcare providers reported a positive perception of family presence on rounds but were concerned about patient confidentiality and perceived efficacy of rounds. Family presence was found to increase rounding time and was felt to negatively impact teaching and opportunities for academic discussions. CONCLUSIONS:Family presence on rounds has potential advantages for family and healthcare providers, but important challenges exist. Further studies are needed to understand how to best implement family presence on adult ICU rounds.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Family Presence on Rounds in Adult Critical Care: A Scoping Review

Calderone

Debay

Goldfarb

2022

Critical Care Explorations

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“…Prior pediatric and adult research suggests that virtual FCR is meaningful to patients, families, and clinicians. [21][22][23][24] Prior research has examined virtual FCR in non-NICU settings using non-randomized designs. 21,22,[25][26][27][28][29] Several studies have brought NICU providers virtually to the bedside, [30][31][32][33][34] but a pilot trial conducted by our research team 24 was the rst clinical trial to bring family members virtually to the NICU bedside.…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

“…[21][22][23][24] Prior research has examined virtual FCR in non-NICU settings using non-randomized designs. 21,22,[25][26][27][28][29] Several studies have brought NICU providers virtually to the bedside, [30][31][32][33][34] but a pilot trial conducted by our research team 24 was the rst clinical trial to bring family members virtually to the NICU bedside. Our pilot trial supported the feasibility of conducting a randomized trial to compare virtual FCR to usual care in the NICU; however, it was limited in that it lacked power for hypothesis testing, had limited outcomes measured, and was conducted in 2020 during COVID-19 shelter-in-place orders.…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit: Protocol for a Cluster Randomized Controlled Trial

Rosenthal

Tancredi

Marcin

et al. 2023

Preprint

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Background: Family-centered rounds is recognized as a best practice for hospitalized children, but it has only been possible for children whose families can physically be at the bedside during hospital rounds. The use of telehealth to bring a family member virtually to the child’s bedside during rounds is a promising solution. We aim to evaluate the impact of virtual family-centered rounds in the neonatal intensive care unit on parental and neonatal outcomes. Methods: This two-arm cluster randomized controlled trial will randomize families of hospitalized infants to have the option to use telehealth for virtual rounds (intervention) or usual care (control). The intervention-arm families will also have the option to participate in rounds in-person or to not participate in rounds. All eligible infants who are admitted to this single-site neonatal intensive care unit during the study period will be included. Eligibility requires that there be an English-proficient adult parent or guardian. We will measure participant-level outcome data to test the impact on family-centered rounds attendance, parent experience, family-centered care, parent activation, parent health-related quality of life, length of stay, breastmilk feeding, and neonatal growth. Additionally, we will conduct a mixed methods implementation evaluation using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework. Discussion: The findings from this trial will increase our understanding about virtual family-centered rounds in the neonatal intensive care unit. The mixed methods implementation evaluation will enhance our understanding about the contextual factors that influence the implementation and rigorous evaluation of our intervention. Trial registration: ClinicalTrials.gov Identifier: NCT05762835. Status: Not yet recruiting. First Posted: 3/10/2023; Last Update Posted: 3/10/2023.

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The business case for patient and family‐centered rounds

Gal,

Khan,

Baird

2023

Journal of Hospital Medicine

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Patient-and family-centered care is a core dimension of modern healthcare, with patient and family-centered rounds (PFCR) being its most tangible manifestation in the inpatient setting. PFCR may vary in structure but generally incorporate discussions at the bedside that include families in formulating the care plan. 1 In pediatrics, PFCR adoption has been extensive. 2 In internal medicine, tenets of PFCR, particularly shared decision-making, have been widely adopted though it is unknown how often formal PFCR are practiced. 3,4 While the value of PFCR is self-evident from ethical and professional perspectives, their financial benefits to hospitals are less clear. A common criticism of PFCR is their time and resource consumption. 1 Additionally, though clinicians may accept PFCR's moral value or acknowledge research demonstrating improved patient outcomes, safety, and experience, 1,2,5-8 they may feel uninvested or un-

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Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit: A Randomized Controlled Pilot Trial

Cited by 18 publications

References 32 publications

Family Presence on Rounds in Adult Critical Care: A Scoping Review

Family Presence on Rounds in Adult Critical Care: A Scoping Review

Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit: Protocol for a Cluster Randomized Controlled Trial

The business case for patient and family‐centered rounds

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