**PAS Oral Presentation PREDICTORS OF FAMILY ENGAGEMENT IN FAMILY-CENTERED ROUNDS

1 May 3, 2014 **PAS Oral Presentation PREDICTORS OF FAMILY ENGAGEMENT IN FAMILY-CENTERED ROUNDS Elizabeth Cox, MD PhD, Victoria Rajamanickam, MS, Tasha Scott, BS, and Gwen Jacobsohn, MA Background: Experts endorse family-centered rounds (FCR) to ensure high quality inpatient care. However, some families may not engage optimally in FCR. Objective: To identify families less engaged in FCR. Design/Methods: Surveys of demographics and hospitalization characteristics and daily videos of FCR were collected from 151 families of children on our hospitalist, hematology, oncology, or pulmonary services. Trained coders assessed family engagement, coding the number of utterances in 4 key visit tasks (relationship building, information giving and gathering, and decision making) from videos using standard methods. To represent family engagement across the child’s stay, the number of utterances for each day of FCR was averaged, for each of the 4 key tasks. Adjusted multivariate negative binomial regression was used to examine associations between engagement and child, parent, and hospitalization factors. Results: Mothers were often present for FCR (89%); fathers were present for 38%. Parent education varied: 19% had a high school education or less, 34% some college, and 47% college graduates. Children were, on average, 5.6 years old (sd 5.6). Common reasons for hospitalization included breathing problems (31%), fever (19%), or gastrointestinal problems (19%). Intercoder reliabilities were near perfect (kappa>0.8). In multivariate models, average family engagement in FCR was significantly associated with the proportion of FCR attended by the mother and less so by the father. For a 5-day stay, each day the mother attended FCR resulted in 13.1% more relationship building, 11.4% more information giving and 26.8% information gathering (all p<0.05). Each day the father attended resulted in 4.3% more relationship building, 1.2% more information giving, and 2.6% information gathering (all p<0.05). Compared to parents with a high school education or less, parents with some college or a bachelor’s degree had significantly more engagement in information giving (47% and 60% more, respectively; p<0.05) and twice as much information gathering (p<0.01). Compared to families whose children stayed 1 day, family engagement in decision making was double for those staying 2-3 days and almost five times greater for those staying >3 days (p<0.01). Conclusion: Support may be needed to optimize engagement for fathers, for parents without any college education, and during short hospital stays. Future work could examine interventions such as peer support or engagement coaches. PAS DATE/TIME/LOCATION 5/3/2014; 11:00 AM11:15AM; East 11 (Vancouver Convention Center)