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Collaboration in Pediatrics.

Collaboration in Pediatrics.

• 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?

No individual individual or entity can tackle each of the well being requirements 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

Crew-structured care for youngsters is different from that for adults for 3 essential factors: (1) early on environment and experience have crucial outcomes on lifelong well being, (2) assets targeted toward well being marketing and condition avoidance have substantial societal benefits, and (3) pediatrics fundamentally contains the dynamic nature of years as a child. 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 unrealistic to assume that any one individual will have the time, resources, or knowledge to address the needs of every family. 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.

Crew-dependent care can be a medical care product that endorses the relationship of kids and households cooperating with a number of health care providers and other staff across several settings to determine, organize, and deal with distributed targets that meet the needs of your entire child. 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 youngsters, they may simply make up the key proper care physician, the little one, and the family. For others, the team may include a wide variety of participants, such as medical and surgical subspecialists, nurse practitioners, physician assistants, nurses, teachers, child care providers, child life specialists, recreational leaders, state and community agencies, home visitors, housing providers, therapists, dietitians and/or nutritionists, care coordinators, social workers, foster care representatives, pharmacists, providers of durable medical equipment, home nursing care, other home health agencies, and medical-legal partnerships.1,5 Finally, the team will transiently expand to include hospital-based physicians and allied health care providers for children who experience inpatient care, with particular attention to timely and accurate communications at admission and discharge.