Disparities in Family-Centered Rounds Participation by Caregiver's Preferred Language

Objective: Data exploring family-centered rounds (FCR) participation for caregivers who prefer a language other than English (LOE) are limited. We sought to characterize baseline rates of LOE-preferring caregiver FCR participation and reasons for not participating, as part of the current state analysis for a QI initiative. Methods: From July 1, 2023 to April 19, 2024, rounding data were recorded, including caregiver presence at bedside and caregiver participation in rounds, for patients admitted to General Pediatrics resident teams at a free-standing children's hospital. For LOE-preferring caregivers, we documented reasons for not joining rounds. We used logistic regression to compare FCR participation rates by preferred language and team; we utilized statistical process control p-charts to visualize participation over time. Results: Data were recorded for 7586 rounding encounters. This included 6781 encounters with English-preferring caregivers and 805 encounters with LOE-preferring caregivers, representing 231 patients with LOE-preferring caregivers. LOE-preferring (70.3%, n=566) and English-preferring (69.7%, n=4725) caregivers were present at bedside with equal frequency. Of caregivers present at bedside, LOE-preferring caregivers participated in 55.6% (n=315) of rounding encounters compared to 88.1% (n=4165) for English-preferring caregivers (P>0.001). The most common reason LOE-preferring caregivers did not participate in FCR was not being invited to join (82%, n=251). LOE-preferring caregiver participation varied over time (27% to 81%), by care team (39% to 91%) and individual LOE (27% to 83%). Conclusions: LOE-preferring caregivers participated in FCR less often than English-preferring caregivers despite similar bedside presence, largely because they were not invited to join. Identifying opportunities to improve LOE-preferring caregiver participation in FCR is essential to ensure the provision of equitable care.