A Video Link at the Bedside: What Happens When NICU Parents Can Join Rounds From Anywhere

How One Hospital Tested Letting Families Watch and Take Part in Their Baby's Daily Care Discussion by Phone or Computer

Every day in the neonatal intensive care unit (NICU), the care team gathers at a baby's bedside for "rounds" — the discussion of how the baby is doing and what comes next. Being there for that conversation is often a parent's clearest window into their baby's care, but distance, work schedules, and other children at home can make daily bedside presence hard for many NICU families. A California children's hospital tested whether adding a video option could help more parents take part.

The Problem This Research Grew Out Of

NICU parents face a particular version of this difficulty. They may have other children to care for, a job they cannot leave, or — especially if their baby was transferred to a large specialized hospital far from home — a drive that takes hours each way. A research team at a children's hospital in Sacramento, California wanted to know: if parents could join rounds by video call instead of only in person, would more of them take part, and would it actually make things better for their families [1]?

The idea that parents should be included in daily rounds, rather than simply told the plan afterward, became the recommended standard for children's hospitals in the United States when national pediatric organizations formally endorsed what is called family-centered care [2]. Early studies found that moving these discussions to the bedside, with parents invited to listen and ask questions, worked well and did not slow the team down [3], and later surveys found that most children's hospitals in the US and Canada had adopted the practice, though how well it was actually done varied a great deal from place to place [4]. When it was done well, parents said they understood their child's care better and felt more respected [5], and one large hospital program that combined bedside rounds with better team communication was even linked to fewer safety mistakes [6] — suggesting that having a parent in the room is not just about making families feel good, but may genuinely help catch problems.

The trouble is that being physically present is much harder for NICU families than for most other families in a hospital. Babies in intensive care, especially at large regional hospitals that receive transfers from smaller hospitals, often stay for weeks or months [7], and it is common for a mother to be well enough to go home from the hospital herself while her baby stays behind — meaning that from very early on, many families are already living apart from their sick newborn [8]. On top of that, the families who live farthest away, who cannot take time off work, or who cannot afford the cost of driving back and forth every day are, research shows, often the same families who already report feeling less included in their child's care to begin with [9]. A hospital video-calling option was proposed as one way to close that gap, and the same research group behind this new study had already tested a smaller, early version of the idea, finding that a video option was workable and — in an early, exploratory look at the data — seemed to help families facing more hardship attend more often [10]. This new, larger study set out to confirm whether that promising early result would hold up.

What the Researchers Did

Between March 2023 and March 2024, the researchers enrolled 486 families of babies in the NICU at a large children's hospital that cares for critically ill newborns from a huge area of Northern California — 33 counties spread across roughly 65,000 square miles, larger than the entire state of West Virginia [1] [11]. Families were split into two groups, roughly two out of every three going into the group offered the video option. To take part, a family needed a parent who was comfortable communicating in English, and the baby needed to be less than a year old; families were not included if there were court-related restrictions on their contact with the baby, if the baby had been in the NICU before, or if they were only admitted on a weekend. The two groups of families were otherwise alike at the start — babies in both groups were born, on average, around 35 weeks of pregnancy (about five weeks early) and weighed about 2.5 kilograms (roughly 5.5 pounds).

Families offered the video option could join rounds live, by video, from a rolling cart with a camera at their baby's bedside, using a secure link sent by text message or email — in addition to, not instead of, being able to come in person as before. A translator could join the call for families who needed one, and technical help was available around the clock. Everything else about rounds stayed the same: the same doctors, nurses, and other specialists took part either way. Families in the other group continued with the usual system, where joining rounds meant being physically at the bedside.

What the Study Found

The results on attendance were striking. Among families offered the video option, a parent took part in over half of all possible rounds (56%), compared with only about 1 in 8 (12%) among families without that option — nearly five times as many rounds attended overall [1]. Most families who used the video option used it as their main way of joining, rather than as an occasional backup to showing up in person. Families offered video access also brought their baby back to the emergency department less often in the month after going home (about 7% versus 14% of families) — a meaningful difference, since fewer emergency visits usually means families felt more confident and prepared managing their baby's care at home.

But the study also turned up a genuine surprise. When researchers asked parents directly how "family-centered" their baby's care felt — meaning how respected, informed, and involved they felt as a family — parents who had been offered the video option actually rated their experience somewhat lower than parents in the usual-care group, not higher. Several other measures, including how confident parents felt managing their baby's care, their own well-being, how long babies stayed in the NICU, breastfeeding rates, weight gain, and how often safety mistakes happened, showed no real difference between the two groups either way. And when the researchers looked more closely, they found that families whose only way to get online was a desktop or laptop computer rather than a smartphone or tablet, or who were less comfortable using technology in general, did not benefit from the video option as much as everyone else — precisely the families a tool like this is often hoped to help most.

What This Means for Families

It is worth sitting for a moment with why more parents joining rounds by video did not translate into parents feeling more looked after, because it is a little counterintuitive. One likely part of the answer is that a phone or laptop screen strips away a lot of the small, wordless things that happen when you are standing at the bedside — a nurse catching your eye, a doctor pausing to see if you look confused, the easy moment after rounds when you can quietly ask a follow-up question. A parent joining by video may also simply be comparing their experience to a different, perhaps higher, standard than a parent who was not expecting to be included at all. The researchers themselves were candid that they cannot yet say for certain which of these explanations, or some combination, is behind the result — only that "more attendance" and "feeling more included" turned out to be two different things worth measuring separately, which is itself a useful lesson for any hospital rolling out a similar program.

If your baby is in the NICU and your hospital offers a video-rounds option, this research suggests it is genuinely worth using if being at the bedside every day is hard for you: it dramatically increases how often parents can be part of the daily conversation about their baby, and it was linked to fewer emergency-room trips after going home — without any downside for the baby's growth, feeding, length of stay, or safety. At the same time, this study is an honest reminder that a video link is not a perfect stand-in for being in the room. It let far more parents take part, but it did not automatically make parents feel more included or more confident, and the researchers themselves are still trying to understand why. If you do not have a reliable smartphone, tablet, or fast internet connection, or you find video technology frustrating, this research found that you may not get the same benefit from a video option as other families do — which is worth telling your care team directly, since past research on family-centered care has found that exactly these kinds of practical hurdles tend to fall hardest on families who are already facing the most difficulty [9], and a good NICU team should be able to offer another way to help you stay involved, such as a loaner device or a staff member who can walk you through it. Before this trial, families who could not physically be at the bedside every day for work, distance, or family reasons had, in effect, only one path to being part of rounds; researchers are now working on figuring out how to make virtual participation feel as genuinely included as being there in person, not just more frequent [1], and on reaching the families that a video link alone still leaves behind.

References

  1. Rosenthal JL, Hoffman KR, Tancredi DJ, et al. NICU Virtual Family-Centered Rounds: A Cluster Randomized Controlled Trial. Pediatrics. 2026;157(2):e2025073588. doi:10.1542/peds.2025-073588 ↩
  2. Committee on Hospital Care and Institute for Patient- and Family-Centered Care. Patient- and family-centered care and the pediatrician's role. Pediatrics. 2012;129(2):394-404. doi:10.1542/peds.2011-3084 ↩
  3. Landry MA, Lafrenaye S, Roy MC, Cyr C. A randomized, controlled trial of bedside versus conference-room case presentation in a pediatric intensive care unit. Pediatrics. 2007;120(2):275-280. doi:10.1542/peds.2007-0107 ↩
  4. Mittal VS, Sigrest T, Ottolini MC, et al. Family-centered rounds on pediatric wards: a PRIS network survey of US and Canadian hospitalists. Pediatrics. 2010;126(1):37-43. doi:10.1542/peds.2009-2364 ↩
  5. Kuo DZ, Sisterhen LL, Sigrest TE, Biazo JM, Aitken ME, Smith CE. Family experiences and pediatric health services use associated with family-centered rounds. Pediatrics. 2012;130(2):299-305. doi:10.1542/peds.2011-2623 ↩
  6. Khan A, Spector ND, Baird JD, et al. Patient safety after implementation of a coproduced family centered communication programme: multicenter before and after intervention study. BMJ. 2018;363:k4764. doi:10.1136/bmj.k4764 ↩
  7. Lee HC, Bennett MV, Schulman J, Gould JB, Profit J. Estimating length of stay by patient type in the neonatal intensive care unit. American Journal of Perinatology. 2016;33(8):751-757. doi:10.1055/s-0036-1572433 ↩
  8. Ray JG, Urquia ML, Berger H, Vermeulen MJ. Maternal and neonatal separation and mortality associated with concurrent admissions to intensive care units. CMAJ. 2012;184(18):E956-E962. doi:10.1503/cmaj.121283 ↩
  9. Guerrero AD, Chen J, Inkelas M, Rodriguez HP, Ortega AN. Racial and ethnic disparities in pediatric experiences of family-centered care. Medical Care. 2010;48(4):388-393. doi:10.1097/MLR.0b013e3181ca3ef7 ↩
  10. Rosenthal JL, Sauers-Ford HS, Williams J, Ranu J, Tancredi DJ, Hoffman KR. Virtual Family-Centered Rounds in the Neonatal Intensive Care Unit: A Randomized Controlled Pilot Trial. Academic Pediatrics. 2021;21(7):1244-1252. doi:10.1016/j.acap.2021.03.007 ↩
  11. Rosenthal JL, Tancredi DJ, Marcin JP, et al. Virtual family-centered hospital rounds in the neonatal intensive care unit: protocol for a cluster randomized controlled trial. Trials. 2023;24(1):331. doi:10.1186/s13063-023-07340-x ↩