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Training in patient- and family-centered care is endorsed by the American Academy of Pediatrics (AAP) and the Accreditation Council for Graduate Medical Education (ACGME) for learners. The AAP recommends patient- and family-centered rounds (PFCR) during inpatient care. The PEA-21 (21-item Presenter Empowerment Action checklist) was developed to evaluate presenter behavior during PFCR. To gather validity evidence for the PEA-21 in evaluating third year medical student and intern presentations during PFCR in the domains of Data Accuracy, Communication Skills, Assessment and Plan Formation, and Family Interaction. A 24-month prospective cohort study of students and interns presenting on PFCR. Content, response process, internal structure, and relationship with other variables were assessed. Data were collected from 101 rounds (758 individual patient encounters), both on pediatric subspecialty and hospital medicine teams. Presenters included third- and fourth-year medical students and interns in pediatrics, internal medicine-pediatrics, and family-medicine. Intraclass correlations between observers ranged from 0.5 to 0.72. Internal consistency showed α >0.7 for 3 of 4 domains. Interns scored higher than students across domains (P <.01), but students' scores improved throughout their rotations (d = 0.2–0.8). Both groups performed lowest in the Family Interaction Domain. The PEA-21 showed strong validity properties including content, response process, internal structure, and relationship with other variables and can be used by educators to assess learners' skill levels and provide formative feedback to both medical students and interns. Targeted efforts are needed to improve skills within the Family Interaction Domain for both medical students and interns. [ABSTRACT FROM AUTHOR]

Patient- and family-centered rounds (PFCR) are used to accomplish work in key areas (patient care, education, family experience) and require considerable work from those involved (time). Limited research has evaluated rounds length, but not efficiency. We sought to evaluate rounds efficiency using the physics-based concept of work output divided by work input. 1) Establish baseline for clinical work (CW), educational effectiveness (EE), family experience (FE) and rounds length (RL); and 2) Develop a rounds efficiency index (REI) construct. This project aimed to establish baseline data for 4 components of rounds efficiency on 5 inpatient acute care teams at Children's Wisconsin. Process measures included 3 types of work output (CW, EE, FE) and work input (RL). CW was evaluated as the percent (%) of daily orders placed on rounds abstracted from the electronic health record on a 10-point rating system corresponding to decile (higher ratings with higher % of daily orders on rounds). EE was assessed as a 1 to 10 rating by learners. FE was assessed as a 1 to 10 rating by families during post-rounds interviews by a rounds coach. RL was recorded in minutes/patient. The outcome measure (REI) was calculated as a ratio of work output/work input (%). A 3-month period of baseline data assessments were collected. The REI was calculated using aggregate ratings for CW, EE, FE, and RL. CW analysis of 809 weekday orders (described as % of daily orders placed on rounds/percentile/CW rating) were: 55%/80th/8; 38%/50th/5; 26%/20th/2. 59 EE ratings had a median of 7 (interquartile range [IQR] 1.3). 21 FE ratings had a median of 9 (IQR 2). 60 RL measurements demonstrated mean of 11.4 minutes/patient (SD 3.2). The average REI was 62%. This project yielded a novel efficiency construct incorporating patient care, educational effectiveness, family experience, and rounds length. Our teams are currently 62% efficient. The REI is a promising tool that provides the basis for providing feedback and targeting interventions for programs seeking to improve rounds efficiency. [ABSTRACT FROM AUTHOR]

The article discusses a study which assessed the use of video conferencing to maintain family and resident involvement in patient rounds during the COVID-19 pandemic. Topics covered include the core principles of Patient and Family Centered Rounds (PFCR), family preferences regarding rounds format, and qualitative feedback about PFCT.