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Collaboration in Pediatric Primary Care

Collaboration in Pediatric Primary Care

• From your observations and experiences in your pediatric clinical rotation, provide an example of multidisciplinary collaboration.
• From your observations and experiences in your pediatric clinical rotation, provide an example of how multidisciplinary and family collaboration affect patient outcomes.
• Discuss how you have been able to promote communication and collaboration among healthcare professionals, patients, and family/caregivers.
• Discuss a particular case where collaboration among healthcare professionals and family members affected patient/family satisfaction.
• In your clinical practicum, what are some barriers you have observed to collaboration among health care professionals, patients, and families?

The American Academy of Pediatrics (AAP) understands that children’s unique and ever-shifting demands depend upon many different help solutions. Key components of effective support systems address the needs of the child and family in the context of their home and community and are dynamic so that they reflect, monitor, and respond to changes as the needs of the child and family change. The AAP believes that team-based care involving medical providers and community partners (eg, teachers and state agencies) is a crucial and necessary component of providing high-quality care to children and their families. Team-based care builds on the foundation of the medical home by reaching out to a potentially broad array of participants in the life of a child and incorporating them into the care provided. Importantly, the AAP believes that a high-functioning team includes children and their families as essential partners. The overall goal of team-based care is to enhance communication and cooperation among the varied medical, social, and educational partners in a child’s life to better meet the global needs of children and their families, helping them to achieve their best potential. In support of the team-based approach, the AAP urges stakeholders to invest in infrastructure, education, and privacy-secured technology to meet the needs of children. This statement includes limited specific examples of potential team members, including health care providers and community partners, that are meant to be illustrative and in no way represent a complete or comprehensive listing of all team members who may be of importance for a specific child and family.

No single individual or organization can address all the health demands of any child. Because most children lack decisional rights, they are a particularly vulnerable population; their needs are inextricably linked to those of their families and communities. Children depend on adults and a variety of support systems for their well-being and to access, obtain, and coordinate care.1,2 Key components of effective support systems address the needs of the child and family in the context of their home and community and are dynamic so that they reflect, monitor, and respond to changes that occur during growth and development. Traditional health care models often fail to adequately address many issues affecting child health. For example, pediatricians often lack adequate time and/or support needed to coordinate with all of a child’s caregivers in the management of children with medical complexity and those with more common chronic medical conditions, such as asthma, diabetes, obesity, or attention-deficit/hyperactivity disorder.3,4 Coordinating feedback from caregivers, schools, dietitians and/or nutritionists, specialists, pharmacies, nursing agencies, vendors of durable medical equipment, and other home care agencies and counselors is regularly needed for many of these conditions.5

Team-structured look after young children is different from that for grownups for 3 key reasons: (1) earlier atmosphere and activities have crucial results on long-term health, (2) sources particular toward well being marketing and condition prevention have considerable societal positive aspects, and (3) pediatrics fundamentally includes the powerful mother nature of childhood. Adverse childhood experiences and toxic stress6 can lead to lifelong physical and mental health challenges and exacerbate chronic conditions. It is essential that children and families who have experienced such toxic stress be identified and supported so that the potential adverse effects on the child’s health and development can be mitigated.7 Team-based care can extend available resources and support children and families affected by adverse childhood experiences. Additionally, children’s needs change as they develop. Compared with adults, children undergo rapid changes physiologically, emotionally, developmentally, and socially over relatively short periods of time. The dynamic nature of infancy, childhood, adolescence, and early adulthood demands a team with the capacity for ongoing evolution timed to these developmental changes. For example, expert breastfeeding support may be a critical part of an infant’s care team, and behavioral health expertise is imperative for assisting youth who are depressed or anxious. In early childhood, team collaboration with home-visiting or young family support programs may be important resources for families. Teenagers may derive benefits from community involvement to bolster the development of healthy relationships and social awareness. A recent statement from the American College of Obstetricians and Gynecologists describes team care in those settings,8 and, recognizing insights from that statement, the American Academy of Pediatrics (AAP) strongly supports pediatric-specific models of team-based care.

It is actually impractical to believe that any one individual can have enough time, sources, or expertise to deal with the requirements every family members. Team-based care for children aims to address the unique aspects of childhood, such as preventive care, health promotion, and health maintenance to promote long-term health, as well as child development and its influence on disease presentation and management.5 Other unique concerns include health consequences from adversity, toxic stress, and social determinants, of which poverty is one of the most important critical determining factors,9 and complex acute and chronic conditions, including mental health problems.10 A team-based approach can facilitate navigation of a fragmented and changing health care financing system with associated gaps in care. Team-based pediatric care has the potential to meet these needs, improve outcomes for children and families, improve population health, and begin to address health equity.

Team-dependent attention is actually a healthcare version that endorses the partnership of children and people cooperating with one or more medical service providers and also other associates across a number of options to recognize, coordinate, and deal with shared targets that meet the requirements from the total little one. Team-based care is considered a foundational element of the patient-centered medical home. The AAP conceptualized the medical home in 1967 and first defined it in a policy statement in 1992.11 The medical home focuses on building a team of professionals responsible for coordinating a patient’s care across the health care continuum and through the changing health care needs that occur from early infancy to adulthood. Ideally, primary care providers within the medical home offer preventive care and surveillance for potential emerging problems, as recommended by Bright Futures guidelines. The medical home typically can provide urgent care for most acute illnesses. The medical home staff awareness of more serious illnesses helps to coordinate smooth transitions between the office and emergency centers, subspecialists, or inpatient hospital units. The medical home also coordinates more complex care for children with temporary or permanent special needs. Team-based care is one of the most important tools used by effective medical homes to meet these goals.5

For a few young children, they may simply comprise the primary treatment physician, the little one, as well as the loved ones. For other people, they may include numerous participants, including health-related and medical subspecialists, health care worker practitioners, physician assistants, nursing staff, educators, little one attention service providers, youngster life professionals, leisurely executives, state and community organizations, residence visitors, property providers, counselors, dietitians and/or nutrition experts, treatment coordinators, interpersonal personnel, foster care associates, pharmacy technician, service providers of long lasting health care gear, house nursing treatment, other house health companies, and healthcare-legal relationships.1,5 Eventually, the group will transiently develop to include healthcare facility-based doctors and allied medical service providers for children who expertise inpatient proper care, with specific awareness of appropriate and exact communication at entry and discharge.5

Report on Evidence for Pediatric Group-Dependent Care A literature look for of PubMed which uses the search phrases “team-based proper care,” “pediatric group-dependent treatment,” “team-based practice,” and “collaborative practice” revealed small official and generalizable research on the potency of group-structured attention in pediatrics and precluded a organized analysis in the pediatric literature for this declaration. In adults, the efficacy of team-based care has been demonstrated on a large scale, particularly for adults with chronic care needs. For example, for adults enrolled in an integrated health care system, team-based care was associated with higher quality of care, lower acute care utilization, and higher cost savings.11 In children, despite a clear need for generalizable evidence-based practice in this area, single-center research reveals some efficacy on health maintenance, prevention of disease, acute illness management, and chronic disease management.12 On the basis of information learned from programs serving children with cystic fibrosis or cancer and their families, multidisciplinary teams are essential in meeting the nursing, mental health, and social service needs of children and families; such teams are also essential in engaging with educational professionals to help a child reenter school after a long hospital or home care experience.2,12–15 Research is needed to document the value and improved outcomes of team-based care in pediatric populations, and the unique care needs of children must be incorporated into such studies.16

The purpose of staff-centered attention is to much better meet the needs of children and families and assist them to attain their finest prospective.