School of Medicine and Health Sciences Poster Presentations

Title

Understanding Nurse, Family, & Interpreter Involvement in Family-Centered Rounds at Children’s National Medical Center

Poster Number

329

Document Type

Poster

Status

Medical Student

Abstract Category

Quality Improvement

Keywords

family-centered rounds, communication, technology, limited-English proficiency, quality improvement

Publication Date

Spring 2018

Abstract

Family-Centered Rounds (FCR) is a model that emphasizes bedside rounding with intentional inclusion of the patient and family in partnership with physicians, nurses, and staff. Challenges to conducting successful FCR include language barriers and a lack of a reliable notification system for all parties. These barriers can be overcome through the development of a FCR mobile application to improve communication and coordination between the stakeholders involved in a child’s care.

This study analyzed data on nurse, interpreter, and family inclusion in FCR. Objective observations of daily FCR - measures of medical team communication with nurses, stakeholder presence, and licensed interpreter use for limited-English proficiency (LEP) families - were recorded using REDCap. REDCap was also used to survey physicians and nurses for a subjective measure of team communication and nurse presence at FCR.

Physicians self-reported contacting nurses 80% of the time for FCR. However, objective measures showed that they contacted nurses only 59% of the time. When contacted before rounds started, more nurses were present for the entire duration of FCR. Additionally, their presence any time during FCR increased by 31% compared to nurses who were contacted at/after the start of rounds. This indicates the importance of early notification, a task which can be better facilitated by a mobile app. The most common barrier reported by physicians is nurses not answering their phones. The leading reason nurses self-report for missing FCR is patient care duties, which could explain their inability to answer their phones at all times. The mobile app will resolve this dilemma by providing a text notification option, a method which more than 55% of nurses and doctors are willing to use.

Language is another barrier to conducting successful FCR. Although LEP families were present more often than English proficient (EP) families, they were offered FCR less frequently. Also, a licensed interpreter was only offered 58% of the time. This study demonstrates a need to better facilitate FCR among doctors, nurses, families and interpreters at Children’s National. The data shows low nurse attendance, disparities in FCR being offered to LEP vs EP families, and a lack of licensed interpreter use.

We propose that technology such as a mobile app notification system can facilitate better communication and coordination between all parties, ultimately improving patient care.

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Creative Commons License
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Understanding Nurse, Family, & Interpreter Involvement in Family-Centered Rounds at Children’s National Medical Center

Family-Centered Rounds (FCR) is a model that emphasizes bedside rounding with intentional inclusion of the patient and family in partnership with physicians, nurses, and staff. Challenges to conducting successful FCR include language barriers and a lack of a reliable notification system for all parties. These barriers can be overcome through the development of a FCR mobile application to improve communication and coordination between the stakeholders involved in a child’s care.

This study analyzed data on nurse, interpreter, and family inclusion in FCR. Objective observations of daily FCR - measures of medical team communication with nurses, stakeholder presence, and licensed interpreter use for limited-English proficiency (LEP) families - were recorded using REDCap. REDCap was also used to survey physicians and nurses for a subjective measure of team communication and nurse presence at FCR.

Physicians self-reported contacting nurses 80% of the time for FCR. However, objective measures showed that they contacted nurses only 59% of the time. When contacted before rounds started, more nurses were present for the entire duration of FCR. Additionally, their presence any time during FCR increased by 31% compared to nurses who were contacted at/after the start of rounds. This indicates the importance of early notification, a task which can be better facilitated by a mobile app. The most common barrier reported by physicians is nurses not answering their phones. The leading reason nurses self-report for missing FCR is patient care duties, which could explain their inability to answer their phones at all times. The mobile app will resolve this dilemma by providing a text notification option, a method which more than 55% of nurses and doctors are willing to use.

Language is another barrier to conducting successful FCR. Although LEP families were present more often than English proficient (EP) families, they were offered FCR less frequently. Also, a licensed interpreter was only offered 58% of the time. This study demonstrates a need to better facilitate FCR among doctors, nurses, families and interpreters at Children’s National. The data shows low nurse attendance, disparities in FCR being offered to LEP vs EP families, and a lack of licensed interpreter use.

We propose that technology such as a mobile app notification system can facilitate better communication and coordination between all parties, ultimately improving patient care.