Abstract
BACKGROUND: Family-centered care (FCC) contributes to improved health care delivery and outcomes in pediatrics. OBJECTIVE: To conduct a global survey of hospital leaders' views on FCC culture, policies, and practices in health care organizations serving children, including in the post-COVID-19 pandemic era. RESEARCH DESIGN: A cross-sectional electronic survey. RESULTS: Surveys were received from 256 leaders from 215 hospitals in 38 countries. Preliminary psychometric analysis yielded a 44-item instrument wherein a higher total score indicated leaders had more positive views of their hospital's FCC. A majority reported high levels of FCC culture at bedside and supportive policies for family presence and participation. Fewer leaders reported family partnership at the organizational level, health professional education on FCC, or organizational accountability for FCC. In multivariable analyses, having an active patient and family advisory council (PFAC) was associated with higher FCC scores. Free-text comments reflected respondents' commitment to family presence and participation in care and decision-making, factors that facilitated or impeded active PFACs, variability in FCC practices, and the COVID-19 pandemic's impact on FCC. CONCLUSIONS: These findings suggest a commitment to FCC by leaders in hospitals providing pediatric care globally, and that an active PFAC is associated with higher ratings of hospital FCC culture, policies, and practices. Expanded adoption of PFACs, along with standardized measurement and quality improvement monitoring, may improve the family-centeredness of pediatric health care, and thereby contribute to quality and safety. Barriers such as a lack of organizational accountability for FCC must be addressed so that FCC can function optimally in pediatric settings.