484 - Analysis of Team Performance During Patient- and Family-Centered Rounds During COVID-19

Poster Number: 484
Publication Number: 484.221

Sarah C. Yale, Medical College of Wisconsin, Milwaukee, WI, United States; Sarah Dyke, Medical College of Wisconsin, Milwaukee, WI, United States; Kelly Lynch, Medical College of Wisconsin, Muskego, WI, United States; Amanda Rogers, Medical College of Wisconsin, Milwaukee, WI, United States; Heather Toth, Medical College of Wisconsin, Milwaukee, WI, United States; Michael Weisgerber, Medical college of Wisconsin, Milwaukee, WI, United States

Background: Patient- and Family- Centered Rounds (PFCR) ensure effective patient care and shared decision-making with families. To improve PFCR, we have implemented a parent coaching program to elicit family feedback on team performance during rounds.

Objective: We sought to understand the evolution of the family experience during Patient and Family Centered Rounds (PFCR) on traditional resident acute care teams over the course of the COVID-19 pandemic.

Design/Methods: We performed semi-structured interviews of families regarding their PFCR experience including positive and negative elements of team performance on two resident teams from 2/2018 to 9/2022. A conventional content analysis was performed. Interview timing was grouped into four phases (P) [P1-pre-pandemic, P2-early pandemic (significant changes in patient placement and team workflow), P3-mid-pandemic (return to pre-pandemic system with lower census), P4-late pandemic (pre-pandemic system and high census)]. Results were also grouped by rounds format: patient room, hallway, or telerounding.

Results: 481 interviews were analyzed through an iterative process identifying 1858 elements, 150 subthemes, 35 themes, and 7 categories.
Results by pandemic phase: The highest percentage of elements were in the category of Communication and Family Understanding regardless of pandemic phase (P) (P1: 27%, P2: 32%, P3: 33%, P4: 36%), followed by Family Interactions (23%, 26%, 25%, 24%), Summative Terms (15%, 21%, 22%, 20%), and System Organization and Logistics (13%, 12%, 11%, 9%). New themes arose in P2-4 that were not present in pre-pandemic P1 including Use of Technology and Keeping Family Informed. P3 had the highest percentage of negative comments in the most categories: Family Interactions (25% negative in P3 vs 5-10% negative in P2-4) , Nursing/Other providers (50% vs 0-38%), and System Organization and Logistics (48% vs 30-42%). Two of the most common themes identified in every P were “Ensures Family Understanding” (10%, 12%, 12%, 14%) and “Includes Family and Patient" (10%, 17%, 8%, 13%).
Results by rounds format: The most frequent rounds format varied by P: P1, patient room; P2, telerounding; P3-4, hallway. All results were consistent across formats, with Communication and Family Understanding being the most common category mentioned.

Conclusion(s): Despite variation in local systems and rounds format during the pandemic, the most common categories of family feedback about PFCR team performance did not change. The specific themes most frequently mentioned by families were ensuring family understanding and patient and family inclusion on rounds.