NICU Virtual Family-Centered Rounds: A Cluster Randomized Controlled Trial

BACKGROUND AND OBJECTIVE: The use of telehealth to bring a family member virtually to the bedside for family-centered rounds (FCR) is a promising strategy to increase family members' access. We aimed to evaluate the impact of offering families the option to use virtual FCR in the neonatal intensive care unit (NICU) on parental and neonatal outcomes. METHODS: This 2-arm cluster randomized controlled trial assigned families of hospitalized infants to the option of using virtual FCR (intervention) or to usual care (control). Intervention families could also attend FCR in person (usual care). All eligible families of infants who were admitted to this single-site neonatal intensive care unit during the study period were included. Outcomes included FCR attendance, parent experience, family-centered care, parent activation, parent health-related quality of life, length of stay, breastmilk feeding, and neonatal growth. RESULTS: From March 2023 to 2024, 486 families were randomized (325 intervention, 161 control). Infants in the intervention arm were estimated to have 4.81 (95% CI 3.65-6.32) times the parent attendance rate of infants in the control arm (unadjusted incidence rate ratio: 4.62 [95% CI 3.40-6.28]). The intervention arm had 0.37 (95% CI 0.18-0.75) times the adjusted odds of a 30-day emergency department revisit compared with the control arm (unadjusted odds ratio: 0.48 [95% CI 0.25-0.91]). No statistically significant positive intervention effects were observed for other secondary outcomes. CONCLUSIONS: Offering virtual FCR increased parent attendance and reduced 30-day emergency department revisits among NICU infants.