4 Providing the optimal resident education experience during family centered rounds

Background Family Centered Rounds (FCR) allow the medical team to partner with patients and families in medical decision-making, improving patient communication and safety. Our children’s hospital recently increased FCR utilization by implementing geographic-based teams. A balancing measure demonstrated that while the majority of respondents agreed that FCR provided the best patient care, only 20% felt FCR provided the best educational experience. Objectives Increase the percentage of residents with a positive perception of the educational experience on FCR from 20% to 80% in 6 months. Methods The Model for Improvement and sequential PDSA cycles were utilized. A needs assessment was conducted to identify barriers to education (figure 1). The FCR process was standardized to include formal presentations outside patient rooms, addressing several educational experiences previously reported as being negatively impacted by FCR. Rounding duration and the percentage of patients receiving FCR were measured daily, while monthly surveys tracked resident perception of the educational experience. Family satisfaction and comprehension surveys were collected quarterly. Results Residents who perceive FCR as a positive educational experience improved from 20% to 75% (N=8, 6) (figure 2). Patients receiving FCR remained above 80% (N=267, 178, 209). 100% (N=14) of families understood their care plans and remained satisfied with the amount of information presented (figures 3 and 4). Unfortunately, rounds frequently exceeded the allotted time, increasing from 37% to 50% (N=7, 6, 10) (figure 5). Conclusions Hybridization of FCR to include formal presentations resulted in 55% more residents agreeing that FCR provided the best educational experience, while preserving family satisfaction and comprehension. Results may be generalizable to similarly sized residency programs. Future interventions will target barriers and negatively impacted educational activities identified upon re-evaluation of the new FCR structure.