Presentation
Rounding in Pediatric ICUs: A Systems Approach Towards Family and Staff Satisfaction with Design of the ICU
SessionPoster Session 2
DescriptionObjective: This exploratory study examines environmental and other work system components that contribute to the process of family-centered rounds (FCRs) in three pediatric intensive care units (ICUs).
Background: Families play a crucial role in patient care processes within a pediatric ICU. Not only do they assist with patient care, but they also contribute to decision-making, generate new patient information, and care for patients to facilitate discharge or transfer. Similarly, staff members work together to gather patient information and create a patient care plan along with the family and consultants. Therefore, both families and staff members benefit from participating in morning rounds, also known as interdisciplinary bedside rounds or FCRs in an ICU. The literature suggests conducting FCRs at the patient’s bedside. At the same time, it is common practice to conduct FCRs in the hallway outside the patient's room, highlighting the need to study the role of the built environment in supporting FCRs. Very few studies have focused on exploring the impact of the built environment and other work system components, such as tools, people, tasks, and organizational factors, on the process of family-centered rounds in a pediatric ICU.
Methods: This exploratory study employs a multiple-embedded case study design to discern the process of FCRs in three pediatric ICUs, utilizing observations, process, and behavior mapping over 9 weeks.
Results: The findings from this study revealed variations in how the built environment, tasks, organization, and workflows influenced FCRs within the three case studies. Organizational factors played an important role in shaping the FCR workflow at each facility. While most rounds were held in the hallway, a few rounds were conducted in the patient's room, based on the patient’s acuity and family preference. One of the biggest barriers to patient room rounds was the need for infection control and the inability to bring computers into the room with the team. Most family conversations took place at the bedside or in the family zone during patient exams on pre-rounds and in the hallway during rounds with a large interdisciplinary team. Additionally, the hallways were not wide enough to accommodate the rounding team and other unit-level activities, resulting in interruptions.
Conclusions: This study demonstrates the variation in the built environment, work system components, and FCR process across the case studies, highlighting the need for a work system model that encompasses all three stages of FCRs within pediatric ICUs.
Background: Families play a crucial role in patient care processes within a pediatric ICU. Not only do they assist with patient care, but they also contribute to decision-making, generate new patient information, and care for patients to facilitate discharge or transfer. Similarly, staff members work together to gather patient information and create a patient care plan along with the family and consultants. Therefore, both families and staff members benefit from participating in morning rounds, also known as interdisciplinary bedside rounds or FCRs in an ICU. The literature suggests conducting FCRs at the patient’s bedside. At the same time, it is common practice to conduct FCRs in the hallway outside the patient's room, highlighting the need to study the role of the built environment in supporting FCRs. Very few studies have focused on exploring the impact of the built environment and other work system components, such as tools, people, tasks, and organizational factors, on the process of family-centered rounds in a pediatric ICU.
Methods: This exploratory study employs a multiple-embedded case study design to discern the process of FCRs in three pediatric ICUs, utilizing observations, process, and behavior mapping over 9 weeks.
Results: The findings from this study revealed variations in how the built environment, tasks, organization, and workflows influenced FCRs within the three case studies. Organizational factors played an important role in shaping the FCR workflow at each facility. While most rounds were held in the hallway, a few rounds were conducted in the patient's room, based on the patient’s acuity and family preference. One of the biggest barriers to patient room rounds was the need for infection control and the inability to bring computers into the room with the team. Most family conversations took place at the bedside or in the family zone during patient exams on pre-rounds and in the hallway during rounds with a large interdisciplinary team. Additionally, the hallways were not wide enough to accommodate the rounding team and other unit-level activities, resulting in interruptions.
Conclusions: This study demonstrates the variation in the built environment, work system components, and FCR process across the case studies, highlighting the need for a work system model that encompasses all three stages of FCRs within pediatric ICUs.
Event Type
Poster Presentation
TimeTuesday, March 244:45pm - 6:15pm EDT
LocationRhinelander Gallery
Hospital Environments