Date of Award
8-2024
Document Type
Dissertation
Degree Name
Doctor of Philosophy (PhD)
Department
Architecture and Health
Committee Chair/Advisor
Dr. Anjali Joseph
Committee Member
Prof. David Allison
Committee Member
Dr. Natallia Sianko
Committee Member
Dr. Nora Colman,MD
Abstract
Rounding in healthcare settings involves the clinical team making routine trips to the patient room to evaluate the patient and devise a care plan (Lynch, 2015). In ICUs, multiple rounds occur throughout the day based on purpose, location, and timing (Mittal, 2014), including morning, surgical, and post-admission rounds (Gurses & Xiao, 2006). Due to the nature of patient illnesses in ICUs, multidisciplinary rounds are most effective in making patient care decisions (Gurses & Xiao, 2006; Lane et al., 2013).
This study discusses the morning rounds that an attending physician and their team lead to create a plan for the day (Tripathi et al., 2015). Traditionally, morning rounds were conducted without families’ and patients’ involvement in decision-making. Nevertheless, with the advent of patient and family-engaged care (PFEC), most clinical teams encourage family-centered multidisciplinary morning rounds, also known as family-centered rounds (FCRs). FCRs are the only time the entire patient team gathers physically at or near the patient bedside to evaluate the patient and formulate a care plan. Therefore, adequate and appropriately designed ICU spaces are pertinent to encourage interaction among the team members.
FCRs in critical care settings improve shared decision-making and communication between families and team members (Sharma et al., 2022; Stickney et al., 2014; Tripathi et al., 2015). Other benefits of FCRs include improved parental understanding of patient care (Stickney et al., 2014), generation of new information about the patient (Stickney et al., 2014), enhanced collaboration among team members (Blakeney et al., 2021), improved patient outcomes (Gonzalo, Heist, et al., 2014; Ratelle et al., 2019), and improved bedside teaching among staff members (Muething et al., 2007). In contrast, staff concerns about FCRs include reduced patient and family privacy, increased time to complete rounds, reduced teaching opportunities, and reservations about critical patient care discussions (Muething et al., 2007; Stickney et al., 2014).
The Institute of Medicine (US) Committee on Quality of Health Care in America (2001) recommends family engagement as a key to improving the quality and safety of healthcare, and FCRs support that by increasing collaboration and communication among the team and with family members (Landry et al., 2007; Stickney et al., 2014; Tripathi et al., 2015). However, the role of the physical environment in supporting FCRs needs further exploration (Care, 2012; Cypress, 2012; Davidson, 2013). Therefore, this study uses a systems approach to evaluate the pediatric ICU-built environment and its influence on family and staff experiences, communication, and collaboration during FCRs.
Recommended Citation
Goel, Swati, "Environmental Barriers and Facilitators to Family-Centered Rounds in Pediatric Critical Care Settings" (2024). All Dissertations. 3675.
https://open.clemson.edu/all_dissertations/3675
Author ORCID Identifier
https://orcid.org/0000-0002-9785-5333