Healthcare Professionals

Why Our Rounds are Effective

Patient- and family-centered rounds are an active process that facilitates an open exchange of information and ideas among the patient, family and all of the patient’s healthcare providers.

Patient- and family-centered rounds are effective when:

The patient and his family are recognized as the focus of care.
Patients, their families, nurses, physicians and other healthcare providers are actively involved.
The patient and her family are included in all decision making and can discuss the daily plan of care and the anticipated outcomes.
Patients’ and their families’ preferences about their level of involvement in the rounding process are respected and honored.
Teaching for the patient, family and healthcare learners occurs during rounds, and the patient and his family act as teachers for the healthcare learners.
Evidence-based medicine is used as a foundation for care decisions.
The process of care is made more safe, efficient, effective and timely.
Patients and their families are satisfied with care delivery.

Basics of Patient- and Family-Centered Rounds

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Family Choice

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Each family should be educated as to the purpose of rounds and should be given the opportunity to choose a role during the rounding process. If the family has privacy issues or other concerns, these should be addressed before rounds. Remember that some families may desire to have certain conversations outside of their child’s hearing. We have found that posting a preference card outside of the patient’s room helps in preparing for rounds. At all times, respect the patient’s and family’s wishes.

Setting the Stage

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Before beginning rounds, make sure key people are present and ready to engage in the rounding process. It is useful to agree on each person’s specific role and responsibilities.
The patient or family should be asked if they are ready to begin rounds.
Make introductions of the team members and refer to the family in the terms they prefer.
Establish rapport with the patient and family by the use of appropriate “ice breakers” such as:
- “Good Morning. We are sorry to wake you.”
- 'What a beautiful baby. Congratulations.”
- “That’s a really cute stuffed animal. What is its name?”
Ask permission to turn the light on, turn off the video games, or turn down the volume of the television.
Position the key participants in a manner that includes the family.
Consider having the key healthcare team member sit down if the family is seated.

Developing the Care Plan

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It is important for the family to be an integral part of the care team by exchanging information. This can be facilitated by using such phrases as:

“I’m going to review the story so the entire group understands what brought you to the hospital. Please add or correct anything as I go along.”
“Let’s review what has happened over the last 24 hours. Your input is very important, so please let me know if I missed anything.”
“You are the expert on your child and family. We’ll make better decisions by working together.”

The family and key members of the care team should have the opportunity to have input and ask questions during rounds.

The daily assessment and plan of care should be discussed and agreed upon by the family and the care team. The family should be given the opportunity to review their understanding of the plan.

Discharge goals should be introduced on the first hospital day and reviewed on each subsequent day.

Closing the Loop and Completing Rounds

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Any issues that will require follow-up before the next time rounds occur should be discussed and specific action plans developed. This includes how any additional information will be relayed to the family.

If the family requires additional time, schedule it with the family before the healthcare team leaves the room.

Any last-minute concerns should be addressed before leaving the room.

The care team should thank the family for their help and assistance.