The Power of Presence is an interview series that explores the experiences of physicians, nurses and families who have used Q-rounds; they are not compensated for sharing their stories, and responses have been edited for length and clarity.
Ryan and Anna McQuillan’s twins, James and Mary Grace, joined the world at the tender age of 22 weeks and five days. Their family used Q-rounds for 3 months while the twins were in the NICU at M Health Fairview Masonic Children’s Hospital. Q-rounds caught up with Ryan to talk to him about his family’s experience.
“Being involved in rounds was the most important thing we could have done, because it was really all we could do.”
When did you start using Q-rounds?
Ryan: It was chaotic when James and Mary Grace were born—they were very critical, and our focus was on making sure they were okay. Our care team said, “We’re signing you up for Q-rounds so you can participate in rounding every day.” We didn’t know what rounds meant; we just gave them our phone number. Then we started getting texts every morning letting us know our position in the rounding queue and estimated start time for rounds.
“There’s no reason, with all the technology and advances that we have in the hospital today, that you shouldn’t have at least a time window when you’re going to meet with your Care Team. It’s a simple and elegant solution to a real problem—that I didn’t know was a problem.”
What are rounds?
Ryan: For parents in the NICU environment that want to be involved, rounds are the time to do that. The Q-rounds text alerts allowed Anna and I to be at rounds more frequently, because we could plan our day around rounds, including whether to attend in-person or virtually. We couldn’t do what was natural for a parent to want to do—we couldn’t physically help James and Mary Grace—but we could go to rounds every day. That also allowed Anna and I to see what did or didn’t work, care-wise, with their personalities, and we could share that information with the care team.
“There’s a measurable difference between being present during rounds or getting an update after the fact. Q-rounds felt like getting an invitation—Here’s when rounds are going to be. Come participate, collaborate with us, instead of, ‘Here’s what was talked about and the changes we’re going to make.’”
How does Q-rounds work?
Ryan: It’s funny to think of a scheduling app being able to provide that big of an impact, but if you’re not at rounds, you’re not building relationships with your care team. Not only from an advocacy standpoint, but we built relationships with the doctors, the unit leaders, the nurses and nurse practitioners. They had a vested interest in us, and we had a vested interest in them. Knowing our care team outside of the actual care provided, made for a much more human experience.
“Why wouldn’t you want as much collaboration, input and communication as possible with patients and their families? If you care about providing the best care possible, [Q-rounds] seems like a no-brainer. Without being able to meet with the care team daily, we wouldn’t have had the ability to advocate for James and Mary Grace the way we did. And I give a lot of credit to the care team for listening to us.”
How does knowing when rounds are happening help?
Ryan: We’d been waiting a long time to have kids; it was something Anna and I had been hoping and praying for. We’re fortunate to have twins, but James and Mary Grace had a lot of health complications. Being in the NICU is a scary, stressful time, with a lot of fear and anxiety. Having a level of consistency—knowing the medical team was coming together to talk about what happened the day before, and the plan for the day to come—played a critical role in the care provided to James and Mary Grace.
“Without giving families the ability to be present during rounding, you’re taking away their ability to provide input—and that’s a huge part of what rounds should be.”
What did you appreciate most about Q-rounds?
Ryan: As James and Mary Grace’s health improved, they moved to a different floor within the NICU that doesn’t use Q-rounds. So Anna and I didn’t have the ability to participate and collaborate in the same way that was so helpful from our time on the other floor in the NICU, especially since James was able to come home sooner than Mary Grace.
On several occasions, the absence of Q-rounds meant we missed opportunities to contribute to discussions about Mary Grace's care plan. Consequently, adjustments were made without our input—adjustments we later found problematic and could have been avoided since we were only informed of these changes after they were implemented. Unfortunately, by the time we were made aware, the decisions had already been finalized, leading to a situation where the care plan was eventually reverted back to something closer to what we would have initially suggested.
Rounding it up
At Q-rounds, our goal is to help every family have the most positive experience possible, despite the unfortunate circumstance of having a loved one in the hospital. We want them to be connected with their care team, and able to advocate for their family during daily rounds. That’s why our app sends real-time notifications to patients, families, nurses and other stakeholders of when to arrive for rounds, and gives families the opportunity to join virtually if they can’t be there in person.
