Introduction
Current guidelines recommend inviting family to attend ICU bedside rounds as one way of improving communication and increasing satisfaction1. There is little guidance as to how participation can be optimized so that family members feel valued as team members and the vulnerabilities of having a critically ill loved one are respected while maintaining the efficiency and high quality of rounds2-4. Recent literature has used the term ‘family centered rounds’ when traditional multidisciplinary rounds are adapted to provide family with an invitation to attend, a summary of information discussed, and an opportunity to ask questions 5,6. Such an approach has not consistently demonstrated an improvement in family satisfaction with communication or shared decision-making7,8. Family and providers have differential awareness of roles family may adopt during rounds; more explicit orientation and engagement strategies may help clarify this 4.
We aimed to develop a framework for patient and family centered rounds by defining key structures, processes, facilitators and barriers to optimal family participation, and tools to maximize and mitigate these factors, respectively. Our program of research has included multicenter multi-city ethnographic observations, interviews and focus groups, and a one-day workshop for toolkit development 4,9. In this manuscript we report the development of a guide on how to conduct patient and family centered rounds in a way that balances the needs of both family members and providers.