Conducting FamilyCentered Rounds (FCR) has become a common practice in pediatric hospital medicine. As many learners may be a part of the pediatric inpatient team for a brief time, orientation to the goals and processes of FCR is often difficult. Additionally, many faculty physicians are challenged in finding the right opportunity for constructive feedback regarding communication skills and teamwork.
To develop and implement a rapid assessment tool to engage learners and team members in evaluating FamilyCentered Rounds.
We developed a Brief Rounds Assessment Tool (BRAT), modeled loosely on the concept of an Apgar score. Our goal was to create a score for the FCR process that could be assigned rapidly and consistently focusing on important elements of FCR. We identified six key areas relevant to FCR: Completion of Work, Communication with the Family, Teamwork/Intrateam Communication, Integration of Learners, Addressing Family’s Concerns, and Language. For each area, we created a score from 0 to 2 with higher scores representing more ideal practices. After rounding in a patient room, the inpatient team utilizes the BRAT to assess the quality of the rounding process. The assessment with the BRAT takes about a minute, and provides an opportunity for reflection and plans for improvement for various team members. This opportunity also serves as a reminder to the team about the goals for FCR, and may modify team practices in subsequent patient rooms. According to attending preference and the needs of the team, any team member, from senior resident to third year medical student, from patient nurse to attending physician may assign the BRAT score for any individual patient.
After pilot testing this tool in the fall of 2011, we have found that residents and other team members rapidly orient to the key areas included on the BRAT and seem to change behaviors based on the expectations delineated in the assessment tool. Our assessment tool has increased the attention paid to the quality of the FCR process and has enhanced the understanding of our learners regarding the goals and expectations for FCR. Use of the BRAT has allowed for a more clear delineation of roles during the rounding process, and has increased the amount of feedback provided to the team members. The process of group evaluation also helps to develop a team perspective, encouraging all members to work together.
To cite this abstract:Hudgins A, Thompson A, McKay D, Martin D, Johnson L, Osburn T. Enhancing the Quality of Familycentered Rounds: The Rounding Apgar. Abstract published at Hospital Medicine 2012, April 1-4, San Diego, Calif. Abstract 97704. Journal of Hospital Medicine. 2012; 7 (suppl 2). https://www.shmabstracts.com/abstract/enhancing-the-quality-of-familycentered-rounds-the-rounding-apgar/. Accessed March 20, 2019.