Background:  Pediatric family-centered rounds (FCR) enhance communication, reduce harmful medical errors, and promote health equity. However, there is unequal access to FCR for caregivers who cannot be physically present at the bedside, and these families are not well-represented in the literature. 

Objective: To describe the barriers that caregivers face to being physically present during FCR and identify potential strategies to improve access.                     

Methods:  We designed a prospective mixed-method study for caregivers of patients admitted to the pediatric hospital medicine service at a quaternary academic center. A focus group with the hospital parent advisory councils informed development of a 31-question survey about caregivers’ experiences and needs related to FCR. Potential participants were identified by the rounding medical team and recruited between 12/2023-5/2024. Caregivers completed the survey in-person in their preferred language. We used descriptive statistics for close-ended questions and thematic analysis for open responses.   

Results:  Fifty caregivers completed the survey; 38% reported not always being present during FCR. Most (56%) self-identified as Hispanic or Latino, 32% of participants spoke a language other than English at home, and 60% utilized public insurance. Barriers to being at the bedside included work, childcare, and transportation. Most (86%) caregivers were interested in a virtual option for FCR, and 74% said that another relative may also join if there were a virtual option. Several caregivers requested additional assistance with parking, meals, or transportation. Caregiver suggestions to increase engagement included scheduling rounds at a set time and including caregiver communication preferences during staff handoffs.      

Conclusions:  Our findings highlight barriers families face in engaging in FCR at the bedside. Potential interventions include a virtual option to join rounds, notifying families of the rounding time, and increasing access to financial resources to minimize barriers to in-person participation. This study has implications for improving FCR engagement, access, and equity.