Supporting Family Presence

Institute files Changing Hospital "Visiting" Policies and Practices: Supporting Family Presence and Participation, in response to Obama Administration Proposed Rule on Visitation Rights

Visitation Rights Final Rule 2010

Current "visiting" policies in many of our nation's hospitals, even for traditionally defined "families," are inappropriately restrictive, costly, put patients at risk, and contribute to emotional suffering for both the patient and family, even if administered without a trace of discrimination (Lee, et al., 2007; Spuhler, 2007). Not only is it vital to enact change as President Obama has outlined, including how families are defined, it is also imperative to transform the restrictive policies and practices of many of our nation's hospitals (Berwick & Kotagal, 2004).

Fundamental change is necessary to move away from the current prevailing view that families are visitors. To achieve this, the family must be "respected as part of the care team-never visitors-in every area of the hospital, including the emergency department and the intensive care unit" (Leape et al., 2009, p. 426).

As well as changing the language typically used in "visiting" polices, it is equally important to revise many of the rules and practices that limit the times and places families and other "partners in care" are able to provide support. For a number of years, The Joint Commission has recommended that patients bring a family member or trusted friend with them to the hospital as a safety strategy (McGreevey, 2006).

Recently, the Institute for Patient- and Family-Centered Care formed a working group composed of health care leaders, staff, and patient/family advisors, all with expertise in patient- and family-centered care, to develop a set of guidelines with respect to changing hospital "visiting" policies and practices. Their recommendations are found in the accompanying document, in addition to specific comments regarding restrictions on visitation rights, and the format, style, and language used in policies and procedures.

Also included are Appendix A: Members of the Working Group for Changing Hospital "Visiting" Policies And Practices: Supporting Family Presence and Participation; Appendix B: Guidelines for the Presence and Participation of Families and Other Partners in Care — A Template; and a list of References. Read More...

Additional Resources

American Association of Critical-Care Nurses - Family Visitation in the Adult ICU

American Association of Critical-Care Nurses position statement on Family Presence During Resuscitation and Invasive Procedures

American Association of Critical-Care Nurses presentation on Family Presence During Resuscitation and Invasive Procedures

Changing the Concept of Families as Visitors: Family Presence and Participation bibliography

Family-Centered Rounds Facilitator Guide - Cincinnati Children's Hospital Medical Center

Family Presence During Trauma Activations and Medical Resuscitations in a Pediatric Emergency Department: An Evidence-Based Practice Project

Morgan Stanley Hospital Family-Centered Rounding video

Supporting Family Presence: Key Questions to Ask

For those interested in examining staff practices and hospital infrastructure to determine how well family presence and participation is supported, please download the following resource: Are Families Considered Visitors in Our Hospital or Unit?

Increasingly staff and faculty are including patients and families in the process of rounds. Please download the following resource to view guidelines for conducting patient- and family-centered rounds: Applying Patient and Family-Centered Concepts to Bedside Rounds.

Changing the Concept of Families as Visitors: Supporting Family Presence and Participation, a resource from the Institute for Patient- and Family-Centered Care to assist units and institutions in redesigning "visiting" policies to support family member presence and participation. Please visit our Resources Page.