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April/May 2005
In this issue |
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Putting patient and family centered care
into action |
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Advisors
Ralph D. Feigin,
M.D.
Physician-in-Chief
Texas Children's Hospital
Professor and Chairman
Department of Pediatrics
Baylor College of Medicine
Robert W. Warren, M.D.
Medical Director, Rheumatology Service
Medical Director,
Information Services
Assistant Medical Director, Ambulatory Services
Texas Children's Hospital
Associate
Professor of Pediatrics, Baylor College
of Medicine
Joseph A. Garcia-Prats,
M.D.
Neonatologist
Texas Children's Hospital
Professor of Pediatrics and Professor of Medical Ethics Baylor
College of Medicine
Editor
Cindy Shanley
Marketing and
Public Affairs
Texas Children’s Hospital
832-824-2180
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For members of the Texas Children's Hospital medical staff
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From
the medical staff president
Putting patient and family centered
care
into action
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Robert W. Warren
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By Robert W. Warren, M.D.
At the Quarterly Medical Staff meeting on February 8, I talked briefly about the importance of family centered care for medical and surgical pediatric health care. I want to share the heart of that presentation here for those of you who couldn’t be there.
Family centered care is an approach to the planning, delivery and evaluation of health care that is governed by mutually beneficial partnerships between health care providers, patients and families.
The precepts of family centered care are:
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People are treated with dignity and respect.
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Health care providers communicate and share complete and unbiased information with patients and families in ways that are affirming and useful.
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Patients and family members build on their strengths by participating in experiences that enhance control and independence.
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Collaboration among patients, family members and providers occurs in policy and program development and professional education, as well as in the delivery of care.
Why is all this so important? Literature shows that family centered care leads to higher quality and safer care (supported in
"Crossing the Quality of Chasm" by the Institute of Medicine), as well as greater adherence to treatment plans, increased family and professional satisfaction with care (also associated with improved staff retention), improved market position and decreased legal risk.
Embracing family centered care
Texas Children’s Hospital has been extremely supportive of family centered care, which is an integral part of the hospital’s value statement; customer-centered service is one of the hospital’s guiding principles. The inpatient and outpatient unit architecture is all about kids and families feeling “at home.” Family centered care is part of employee training and elemental to many job descriptions and is measured in satisfaction surveys completed by parents.
The hospital has had a Family Advisory Board (FAB) for four years, composed of parents who counsel us about matters such as buildings, parking, clinic flow, our hospital discharge process and the need for “concierge” services. The FAB is staffed by Family Relations, which is directed by Pat Dolan, and includes nursing, physician, social work, senior executives and Board representatives. Ms. Robbie Caldwell is the Family Advisory Board chair.
In addition, the hospital has a number of ongoing initiatives relevant to family centered care, including the new Guest Services program, efforts to improve family access to clinic appointment information and decrease clinic wait times, and now a new Children’s Advisory Board.
What can physicians do to support family centered care?
The American Academy of Pediatrics offered multiple
recommendations in its 2003 Policy Statement. Here is my
“Reader’s Digest” condensed version:
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Respect family insight into child behavior and needs.
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Share information with children and families in ways that are
useful and affirming.
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Offer parents/guardians the option to be present and support
their child during medical procedures.
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Promote active participation of all children and particularly
older children and youth, as well as their parents/guardians, in
the management and direction of their own health care.
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Partner with families in examining systems of care.
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Facilitate family-to-family support and networking.
In January, I asked our Family Advisory Board for very specific advice they might have for doctors. Here’s their Top 10 list:
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Introduce yourself and those with you.
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Offer a business card so we can contact your office if
necessary.
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Address us by name, not “Mom” or “Dad.”
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Sit down when you talk with us.
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Talk to our child, too.
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Be patient and understanding.
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Ensure that we understand the situation and have had ample opportunity to ask questions.
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Tell us what other people and resources you trust; we know you don’t have time to answer every question in great detail.
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Tell us when you don’t know the answer.
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Keep us informed, offer care options and treat us as critical members of the health care team.
I recommend all these ideas to you for your practice.
Robert W. Warren, M.D., is the 2005 president of the medical
staff; medical director, Rheumatology Service; medical director,
Information Services; and assistant medical director, Ambulatory
services at Texas Children’s. He also is associate professor,
Department of Pediatrics, at Baylor College of Medicine.
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Grand Rounds calendar
8:30 a.m., Fridays,
Texas Children's Hospital, lower-level Auditorium unless
otherwise listed.
April 1
Heart Failure in Neonates, Children and Young Adults: Current
Update and Future Strategies
Anthony C. Chang, M.D., Associate Professor of Pediatrics
April 8 (no CME credit)
Fellow’s Day:
Child Abuse 2005
Michelle A. Lyn, M.D., Assistant Professor of Pediatrics
April 22
(Baylor College of Medicine Kleberg Auditorium)
Pediatric Post Graduate Symposium:
Adolescent Weight Gain During Pregnancy –
Blessing Or Curse?
Elizabeth R. McArnarney, M.D., Professor and Chair, Department
of Pediatrics University of Rochester Medical Center
April 29
Topic TBA; Pediatric environmental health
May 6
Summertime Toxicology
Deborah Cherry, M.D., Assistant Professor, Occupational
Health Sciences
May 13
Clinical Pathological Conference: Thrombophilia – What
Pediatricians Should Know
Jun Teruya, M.D., D.Sc., Assistant Professor of Pathology
May 20
Caring for Children with Life-Threatening Illnesses: Can We Do
Better?
Joanne Wolfe, M.D., MPH, Assistant Professor of Pediatrics
at Harvard Medical School
May 27
Topic to be announced
Larry S. Jefferson, M.D., Associate Professor of Pediatrics
June 3
Sepsis in Infants and Children
Laura L. Loftis, M.D., Associate Professor of Pediatrics
June 10
Update on Inflammatory Bowel Disease
Anthony P. Olive, M.D., Assistant Professor of Pediatrics
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