Family-Centered Rounds Versus Traditional Rounds in Pediatric Inpatient Units: Effects on Parental Satisfaction and Length of Stay

Abstract

Introduction: Family-centered rounds (FCR) involve parents actively in medical decision-making at the bedside. While widely advocated, evidence for FCR’s impact on clinical outcomes and parental experience remains mixed. This review compares FCR to traditional rounds (TR, conducted outside patient rooms) in pediatric general inpatient settings.

Methods: Systematic search of Medline, CINAHL, and PsycINFO for controlled trials and pre-post studies comparing FCR vs. TR in children aged 0–18 years admitted to non-ICU wards. Primary outcomes: parental satisfaction (validated scores, 0–100 scale), hospital length of stay (LOS). Secondary: medication errors, readmission rates. Random-effects meta-analysis.

Results: Eleven studies (n=3,847 patient encounters) met inclusion: 4 RCTs, 7 quasi-experimental. Parental satisfaction was significantly higher with FCR (mean difference +8.2 points, 95% CI 5.4–11.0, p<0.001). LOS was unchanged (mean difference –0.2 days, 95% CI –0.7 to +0.3). Medication errors decreased by 18% (RR 0.82, 95% CI 0.68–0.99). Thirty-day readmission did not differ. Rounds duration increased by 4 minutes per patient on FCR (p=0.02).

Discussion: FCR improves parent satisfaction without prolonging hospitalization, though rounds take slightly longer. Error reduction suggests enhanced information sharing. Barriers to FCR adoption include resident discomfort with parental questioning and time constraints in high-volume services.

Conclusions: Family-centered rounds are superior to traditional rounds for parental satisfaction and medication safety. Institutions should implement FCR with training for medical teams to manage round efficiency.