General Pediatric Hospitalist Childrens Hospital of Philadelphia Philadelphia, Pennsylvania, United States
Background: Family-centered rounds (FCR) are the recommended rounding practice of the American Academy of Pediatrics. Prior studies have demonstrated that families who prefer to communicate in a language other than English (LOE) experience differences in rounding structure and filtering of information, report less comfort participating in rounds, and have less time to ask questions compared to families who prefer English. Recently, our freestanding pediatric hospital has seen a substantial increase in caregiver inclusion in FCR on our inpatient General Pediatrics Resident (GPR) teams, but it is not clear if caregiver inclusion differs based on preferred language. Objective: We sought to compare how often caregivers who prefer an LOE and are physically present at the bedside are included in FCR on our GPR teams compared with those who prefer English. Design/Methods: From 6/29/23 - 9/15/23, rounding data, including presence of caregivers at the bedside and participation in FCR, were collected on GPR teams. For caregivers who prefer an LOE who were not included in rounds, we documented the reason for lack of inclusion. Caregivers who prefer an LOE were identified based on their listed preferred language in the electronic medical record or as care team members identified interpreter needs during rounds. We calculated the FCR caregiver inclusion percentage for each patient encounter. We then compared the proportion of caregivers included during rounds between those preferring an LOE and those preferring English using a 2-sample test of proportions. Results: Data were recorded for 1778 rounding encounters, including 1617 for English-preferring families and 161 for LOE-preferring families. Caregivers who prefer an LOE and those who prefer English were present at the bedside with equal frequency (71%). Of those present at the bedside, LOE-preferring caregivers (N=115) were included in rounds 67% (95%CI 58-76%) of the time compared to 85% (95%CI 83-87%) for English-preferring caregivers (N=1149, P<.001). For 79% (n=38) of encounters with LOE-preferring families who were present but not included in rounds, the reason given was “the team chose to provide updates before or after rounds.”
Conclusion(s): Caregivers who prefer an LOE were included in FCR less frequently than English-preferring caregivers, suggesting inequitable utilization of FCR practices. Next steps include exploring the perspectives of care team members and LOE-preferring caregivers to characterize the drivers of this disparity to guide future interventions.
