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Parental Responses to Involvement in Rounds on a Pediatric Inpatient Unit at a Teaching Hospital: A Qualitative Study

Latta, Linda C. RN, PhD, CNAA; Dick, Ronald MD; Parry, Carol MA; Tamura, Glen S. MD, PhD

Academic Medicine:
doi: 10.1097/ACM.0b013e3181637e21
Residents' Education
Abstract

Purpose: In pediatric teaching hospitals, medical decisions are traditionally made by the attending and resident physicians during rounds that do not include parents. This structure limits the ability of the medical team to provide “family-centered care” and the attending physician to model communication skills. The authors thus set out to identify how parents responded to participation in interdisciplinary teaching rounds conducted in a large tertiary care children's teaching hospital.

Method: A qualitative descriptive study was conducted using data from semistructured interviews of parents who had participated in rounds on the inpatient medical unit of a large academic children's hospital. From December 2004 to April 2005, 18 parents were interviewed after their participation in rounds. Questions assessed their experiences, expectations, preferred communication styles, and suggestions for improvement. Transcripts of the interviews were analyzed using qualitative content analysis.

Results: Being able to communicate, understand the plan, and participate with the team in decision making about their child's care were the most frequently cited outcomes of importance to parents. All 18 participants described the overall experience as positive, and 17 of 18 described themselves as “comfortable” with inclusion in rounds. Use of lay terminology and inclusion of nurses in rounds were preferred.

Conclusions: Including parents on ward rounds at a teaching hospital was viewed positively by parents. Specific themes of particular importance to parents were identified. Further study is needed to assess the impact of inclusion of parents on rounds on patient outcomes and the resident experience.

Author Information

Dr. Latta is director of professional nursing practice, development, and research, Children's Hospital and Regional Medical Center, Seattle, Washington.

Dr. Dick is clinical assistant professor of pediatrics, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington.

Ms. Parry is family-centered care coordinator, Children's Hospital and Regional Medical Center, Seattle, Washington.

Dr. Tamura is assistant professor of pediatrics, Department of Pediatrics, University of Washington School of Medicine, and medical director, Inpatient Medical Unit, Children's Hospital and Regional Medical Center, Seattle, Washington.

Correspondence should be addressed to Dr. Tamura, Children's Hospital and Regional Medical Center, 4800 Sand Point Way NE, Seattle, WA 98105-0371; telephone: (206) 987-6487; fax: (206) 987-3890; e-mail: (gtamura@u.washington.edu).

© 2008 Association of American Medical Colleges