There are increasing demands on physicians to provide high-quality care that is patient-centered [1]. Engaging patients is important for patient safety, especially for children who experience three times the medication errors adults do [2]. During a child’s hospitalization, family-centered rounds (FCR) represent a crucial opportunity for healthcare professionals, patients and families to communicate information, solicit input and make decisions about the child’s care. However, no evidence exists as to how family engagement in FCR can be optimized. Our study uses the SEIPS (Systems Engineering Initiative for Patient Safety) model of work system and patient safety [3] to identify barriers and facilitators to family engagement in FCR. According to the SEIPS model [3], care processes influence patient safety, and are influenced by the work system design. This study focuses on the bedside rounding process and the work system factors that influence family engagement in key family-centered care tasks (relationship building, information sharing and decision making)[4].