Goals and Objectives

Family-Centered Care Review Family-Centered Care concepts

Review AAP recommendations on

Family-Centered Care
Division of Pediatric Medical Education Grand Rounds
February 15, 2008

Lorna K Fitzpatrick, MD Discuss how the residency program is

Program Director
practicing Family-Centered Care
Deanna McDonald, MD and Nicole DeLuca, MD
2007-08 Pediatric Chief Residents

Models of Patient Care Models of Patient Care

System-Centered Care: The priorities of Family Focused Care: The family is the
the system and those who work within focus of care with interventions done to
it drive the delivery of health care. and for them, instead of with them.

Patient Focused Care: The patient is Patient and Family-Centered Care: The
the focus of care with interventions priorities of patients and their families
done to and for him/her, instead of with drive the delivery of services.
the patient.

What is Family-Centered Care? Core Concepts

Emphasizes communication and relationships Dignity and Respect Participation
Incorporating the Support family
Creates a partnership between the medical staff, familys knowledge, participation at the
patients and their families to formulate a plan of values, beliefs and level they choose
care culture into the plan
of care
Recognizes the vital role that families play in Information Sharing Collaboration
ensuring the health and well being of children Sharing complete Family involvement
and unbiased in the global health
Acknowledges that emotional, social and information to care arena
developmental support are integral components encourage effective
of health care family participation

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 Paradigm Shift Benefits of Family-Centered Care
Deficits Strengths Enhances patient, family and professional
satisfaction
Control Collaboration
Expert Model Partnership Model Improves clinical decision making and outcomes
Information Gatekeeping Info
Decreases anxiety for patient and family
Sharing
Rigidity Flexibility Health Care Providers have a greater
understanding of a familys strengths and are
Dependence Empowerment more responsive to patient and family needs

Benefits of Family-Centered Care Benefits of Family-Centered Care

Improved communication among More effective and efficient use of
members of the health care team health care resources

Creates a supportive workplace Reduces health care costs and

environment
decreases length of stay

Creates a more effective learning

environment for medical students and Decrease in the number of lawsuits
residents

2003 AAP Policy Statement on 2003 AAP Policy Statement on

Family-Centered Care Family-Centered Care
Ensure that the core concepts of family- Ensure that there are systems in place that
centered care are incorporated into all facilitate children and families access to
aspects of professional practice consumer health information and support

Conduct attending physician rounds in the Encourage and facilitate family-to-family

patients rooms with the family present support and networking

Provide education and training in family-

Create ways for children and families to
centered care to all physicians, nurses,
residents, students and hospital staff serve as advisors

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 2003 AAP Policy Statement on
Family-Centered Care
Design facilities to promote the
philosophy of Family-Centered Care
Hire staff with the expectation of
Family-Centered Care
Conduct research on outcomes and
implementation of Family-Centered
Care
Family-Centered Care and
ACGME Requirements
Residents must be able to provide
family centered patient care that is
culturally effective, developmentally
and age appropriate, compassionate,
and effective for the treatment of
disease and the promotion of health.

Patient and Family Centered

Family-Centered Care Team
Rounds
Attending
4 Key Components
Residents
Creating a partnership
Medical Students Discussion and Planning
Teaching and Learning
Charge Nurse
Dealing with Uncertainty
Pharmacist

Creating a Partnership
Explain rounds and invite family
involvement upon admission

Family choice about involvement on

rounds

Introduce team

3

Patient Presentations
Introductions
Identify what parent wants to be called
Introduces each member of team
Brief introduction about the patient
Patient Presentations
Orders at the bedside - Written and read
aloud to family and team on rounds
Discuss and Review Discharge Goals
Elicit any questions or concerns from the
patient and family
Assure patient and family understanding
Discussion and Planning
Invite families to be a part of the
discussion and position team members
to be inclusive
Led by Intern or Medical Student
Dealing with sensitive and private
issues
Patient Presentations
Engage the Parents they are the
experts on their child (Subjective)
Provide information about the patient in
the last 24 hours Vital signs, physical
exam and review of testing (Objective)
Assessment and plan for the day
4
 Teaching and Learning
Ask family permission to teach
Teaching families while teaching
students and vice versa
Role-modeling skills
Future Goals
Length of stay
Patient and family satisfaction
Resident education
Questions?
Dealing with Uncertainty
Acknowledge uncertainty when present
which is different than We dont know
Assess the familys comfort level and
need for reassurance
Thinking out loud can benefit families
References
Muething, SE, et al. Family-Centered Bedside
Rounds: A New Approach to Patient Care and
Teaching. Pediatrics. 2007,119:829-832.
American Academy of Pediatrics, Committee on
Hospital Care. Family-centered care and the
pediatricians role. Pediatrics. 2003, 112:691-696.
Hospitals Moving Forward with Family-Centered
Care. Institute for Family-Centered Care. April 2007.
www.familycenteredcare.org
www.acgme.org