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Perceptions of Family Participation in

Intensive Care Unit Rounds and


Telemedicine: A Qualitative
Assessment
1. Elisabeth A. Stelson, MSW, MPH,
2. Brendan G. Carr, MD, MPH,
3. Kate E. Golden, MA,
4. Niels Martin, MD,
5. Therese S. Richmond, PhD, CRNP,
6. M. Kit Delgado, MD, MS and
7. Daniel N. Holena, MD, MSCE
+ Author Affiliations
1. Elisabeth A. Stelson is manager of community programs and evaluation
at Lutheran Settlement House, Philadelphia, Pennsylvania. Kate E.
Golden is a clinical research coordinator, Mixed Methods Research Lab,
Department of Family Medicine and Community Health, University of
Pennsylvania, Philadelphia. Brendan G. Carr is vice-dean, Department of
Emergency Medicine, Jefferson University School of Medicine,
Philadelphia. Niels Martin is medical director of the surgical intensive
care unit and assistant professor of surgery, Division of Traumatology,
Surgical Critical Care and Emergency Surgery, Perelman School of
Medicine at the University of Pennsylvania, Philadelphia. Therese S.
Richmond is the Andrea B. Laporte Professor and associate dean for
research and innovation, University of Pennsylvania School of Nursing,
Philadelphia. M. Kit Delgado is an assistant professor of emergency
medicine and epidemiology, Department of Emergency Medicine, a senior
scholar at the Center for Clinical Epidemiology and Biostatistics,
Perelman School of Medicine at the University of Pennsylvania, and a
senior fellow at The Leonard Davis Institute, Wharton School of Business
at the University of Pennsylvania. Daniel N. Holena is an assistant
professor, Division of Traumatology, Surgical Critical Care and

Emergency Surgery and a senior scholar, The Leonard Davis Institute,


Wharton School of Business, University of Pennsylvania.
1. Corresponding author: Daniel Holena, md, msce, Department of Surgery,
University of Pennsylvania School of Medicine, 51 N. 39th St, MOB
Building 1st Floor, Philadelphia PA 19104 (e-mail:
Daniel.holena@uphs.upenn.edu).

Abstract
Background Family-centered rounds involve purposeful interactions between
patients families and care providers to refocus the delivery of care on patients
needs.
Objectives To examine perspectives of patients family members and health care
providers on family participation in rounds in the surgical intensive care unit
(ICU) and the potential use of telemedicine to facilitate this process.
Methods Patients family members and surgical ICU care providers were
recruited for semistructured interviews exploring stakeholders perspectives on
family participation in ICU rounds and the potential role of telemedicine. Thirtytwo interviews were conducted, audio recorded, and transcribed verbatim.
Common coding methods were facilitated by using NVivo 10. A mean coding
agreement of 97.3% was calculated for 22% of transcripts.
Results Both patients family members and health care providers described
inconsistent practices surrounding family participation in ICU rounds as well as
barriers to and facilitators of family participation. Family members identified 3
primary logistical challenges to participation in ICU rounds: distance to hospitals,
work/family obligations, and the rounding schedule. Both family members and
providers reported receptivity to virtual participation as a potential solution to
these challenges.
Conclusions Understanding the barriers to and facilitators of family participation
in ICU rounds is key to encouraging adoption of family-centered rounds. For
families that live far away or have competing demands, telemedical options may
facilitate participation.

2016 American Association of Critical-Care Nurses