Abstract
BACKGROUND: Family-centered rounds (FCR), multi-disciplinary rounds at bedside that involve the patient and family, has become the standard of care in pediatric hospitalizations. Caregiver participation on FCR improves shared-decision making and communication among providers, patients, and families. Evidence suggests Black and Latino (a/e) caregivers participate less during FCR than White caregivers, likely due to interpersonal and structural inequities, however contributing factors have not been adequately explored. OBJECTIVE: To better understand factors positively and negatively influencing Black and Latino (a/e) participation during FCR. DESIGN/METHODS: We conducted a qualitative study of Black and Latino(a/e) caregivers and attending clinicians of hospitalized children admitted to a general pediatrics team at a tertiary care children's hospital. We conducted virtual semi-structured interviews to assess factors that promoted and hindered caregiver participation on FCR. Clinician interviews addressed experiences encouraging caregiver participation on FCR with a focus on Black and Latino(a/e) caregivers. Investigators worked together to organize codes into common themes, select representative quotes, and create a conceptual framework. RESULTS: We conducted 21 interviews (14 caregivers, 7 clinicians) at an academic medical center. From our interviews, caregivers and their clinicians identified four major themes that influenced caregiver participation during rounds: 1) verbal and nonverbal interpersonal communication, 2) shared understanding and language, 3) structural factors (team size and time pressures), and 4) race, racism, and previous healthcare experiences. CONCLUSIONS: Caregivers and their clinicians identified structural and modifiable clinician and health system factors that can promote Black and Latino (a/e) participation on FCR. Future research and interventions focused on these factors may improve not only racial inequities in clinician-caregiver communication, but also pediatric health outcomes.