Inclusion of Parents in Pediatric Subspecialty Team Rounds: Attitudes of the Family and Medical Team

The importance of the family's involvement in caring for children with cancer is as tremendous as the need to successfully educate our medical students and residents about the value of effective communication and family-centered care. This article presents a model of change undertaken by one large pediatric cancer center to improve family-centered care. The author describes how the inclusion of families in sit-down medical team rounds influenced family, medical trainee, and attending physician satisfaction. Despite initial reluctance from the medical team and early challenges, this model was found to be successful and to have improved the standard of care. Each morning, patients' families were given the opportunity to sign up to attend sit-down team rounds while their child's case was discussed. Participation was voluntary, and parents could ask questions and offer input. Together, the student, resident, fellow, family member, and attending formulated the treatment plan for that day. Family and trainee participants were surveyed for their opinions of the new style of rounds. Family satisfaction was unanimously improved. Medical trainees reported mixed opinions. Families reported increased feelings of inclusion, respect, and having a better understanding of their child's care. Trainees recognized the value in patient care and family satisfaction, but some doubted the benefit to their own training. Details of this change, including challenges faced, as well as the descriptive survey results of both the families and medical trainees, are discussed.