On the Same Team

On the Same Team

Patient and Family Centered Rounds put patient at heart of health team

By April Frawley Birdwell


Dr. Michele Lossius and a team of nurses, residents, medical students and other health professionals perform Patient and Family Centered Rounds at Shands Hospital for Children. Photo by Maria Belen Farias

Born three months premature in 1996, Alyssa Mann weighed in at just 1 pound, 4 ounces, about as much as a can of peas. Hydrocephalus, cerebral palsy and other complications have kept the 15 year old in and out of the hospital most of her life, making her mother, Tina Mann, somewhat of an expert when it comes to hospital stays.

Tina remembers doctors and students clustering in the hall outside the hospital room door when Alyssa was small, talking about her daughter’s case in hushed tones. Now, a swarm of medical students, residents, nurses, social workers, other health professionals and an attending physician file into the room, openly discussing the case with each other, and with Tina.

“They make sure you know you are part of the team,” Tina said. “It is beneficial for the kids, and helps the (team) know how to better take care of them.”

The concept is called Patient and Family Centered Rounds, and it has been spreading across pediatrics units at Shands at UF since 2007, when Nicole Paradise Black, M.D., established it as part of the pediatric hospitalist service. Everyone involved in the patient’s care gathers at the bedside and plays a key role in determining what happens next, giving families a voice and increasing efficiency among the health care team.

“Families are not a bystander in the process, there is shared decision-making. It is not just us talking to them, it is us talking with them,” Black said. “It is extremely valuable to get the family’s perspective.”

So valuable, Black and colleague Angela Miney, a family partner in the pediatric pulmonary division, recently received a $23,000 UF&Shands Clinical Quality Award to help expand and improve the program. The funds allow the department to hire a family partner to help increase family and staff involvement, and establish a patient and family advisory council in pediatrics.

Black also wants to continue building involvement with nurses, other health professionals and families. They have boosted nurse participation to 40 percent already, a huge achievement considering rounds occur during a prime medication administration time. But she hopes to engage even more nurses in the process.

“We need to make whatever changes we need to make to have more nurses there. For people who come in to the acute setting, the person you often have the best relationship with is a nurse,” Miney said.

In addition, Black hopes to expand Patient and Family-Centered Rounds to more divisions within pediatrics.

“It’s not perfect. It is not meant for everybody every single day,” Black said. “It is a good process that is meant to hopefully be a good means of information sharing and decision-making, and family members are definitely part of the team.”