CHA – Children’s Hospital Academic Medical Organization
CHA-21-008 – Virtual Family-Centered Rounds: a collaborative necessity during COVID-19 and beyond
Since the initiation of grant funding in April 2021, the study team has completed the following activities, in line with the originally proposed project timeline and objectives:
• obtained research ethics board (REB) approval for mixed methods process evaluation to evaluate virtual family-centered rounds (vFCR) effectiveness, efficiency and satisfaction
• data collection
• data analysis
• development of a virtual family centered rounds toolkit which includes training materials and videos for families, staff and medical staff, implementation guidance, and testimonials from family and hospital leadership.
In April 2021 the study team secured REB approval and began building a multidisciplinary study team, including staff physicians, human factors experts, a medical student, a undergraduate university student, a nurse educator, a pediatric resident, qualitative methodologists and family representatives.
Data collection took place in May and June 2021 via virtual and in-person observations of vFCR and post-vFCR surveys to patients, caregivers, staff and medical staff.
Virtual observations focused on timing and adherence to core components of family-centered rounds (FCR). These were conducted over a three-week period, crossing two scheduling blocks to optimize sample of medical teams where the staff physician and medical learners rotate weekly and monthly respectively. Each of the three inpatient medicine teams was observed three times by a single trained observer. A total of 62 patient rounds were observed virtually. In-person naturalistic observations were conducted over five days and focused on technology interaction and usability. Three observation days were on the inpatient units observing vFCR from the perspective of patients, caregivers and nursing staff. On two days the observer joined the physician teams, in the conference rooms. A total of 40 patient rounds were observed in-person.
Questionnaires were distributed post-vFCR to patients, caregivers and staff. A total of 104 questionnaires were completed (75% response rate) – 42 by patients and caregivers and 62 by members of the medical team. Observation data underwent quantitative and content analysis. Data from post-vFCR questionnaires were subject to descriptive statistical analysis and content analysis of free-text responses. Using unique participant IDs, we attempted to match participant observations with questionnaire responses where possible to enhance the quality of our data.
A vFCR toolkit has been developed which includes resources and materials to support (v)FCR education at our hospital as well as implementation of vFCR in other centres. The development of this toolkit was led by our study team and subject matter experts (ie. information services staff) were consulted as required. Our in-house media and communications departments supported development of toolkit videos and visuals and assisted with the website build.
Toolkit materials include:
• Training tools and tip sheets, videos, and quizzes for staff physicians, learners, nurses, administrative assistants, unit clerks and other healthcare professionals involved in vFCR
• Step-by-step guide for conducting the vFCR process
• Resources for patients and families • Testimonial videos from hospital leadership and families on the benefits of (virtual) family-centered rounds
• Guiding principles for implementing vFCR and process/evaluation tools.
The toolkit will be presented in the form of a webpage hosted on CHEO’s external website. The target launch for the online toolkit is January 2022.
Study abstracts have and will be submitted to conferences focused on pediatric hospital medicine, pediatrics and human factors. A manuscript is currently in progress, with an expectation for publication within the year.
Virtual Health Care
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