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.