Individual domain qualitative content analysis themes | |
---|---|
Facilitators | Construct |
Relatively consistent beliefs regarding which components of family-centered rounds (FCR) are most important | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE increase care team and family understanding of the care plan | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE provides a forum for families to express concerns and to feel engaged and empowered to participate in their child’s care | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE demonstrate respect for the family’s role and increases family awareness of the healthcare team and their connection to the team | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE provide a structure for rounds that benefits the care team, including resident learners | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE take longer but efficiencies are gained throughout the day with fewer follow up questions regarding the plan | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE increase patient and family overall satisfaction with care | Knowledge and beliefs |
Belief that structured FCR approaches like I-PASS SCORE improve care outcomes | Knowledge and beliefs |
Participants express a high level of confidence in their ability to follow structured FCR approaches like I-PASS SCORE | Self-efficacy |
Some individuals intend to use structured FCR approaches like I-PASS SCORE going forward in their practice | Stage of change |
Participants have high confidence that the organization will continue to use structured FCR approaches like I-PASS SCORE when the project is complete | Stage of change |
Barriers | |
Variation in beliefs about the purpose of rounds across stakeholders | Knowledge and beliefs |
Physician with more experience may be less willing to adhere to more structured approaches. | Personal attributes |
Nurses may not believe their attendance on rounds is a priority for the team (e.g., they are not actively included in rounds) and not a good use of their time. | Knowledge and beliefs |
Nurses believe they can address questions regarding the care plan with physicians more efficiently at other times | Knowledge and beliefs |
Family cultural norms (role of authority figures, et al.) effect their level of participation during rounds | Personal attributes |
Presenters/learners do not want to appear “wrong” in front of peers and families | Self-efficacy |
Belief by some participants that family presence and emphasis on use of plain language can limit content discussed during rounds. | Knowledge and beliefs |