Development of a Hospital-Based Care Coordination Program for Children With Special Health Care Needs

Petitgout, Janine M.; Pelzer, Daniel E.; McConkey, Stacy A.; Hanrahan, Kirsten

doi:10.1016/j.pedhc.2012.03.005

Cited by 15 publications

(14 citation statements)

References 10 publications

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“…3). These findings align with reports from community-based complex care clinics showing significant increases in parental perception of care coordination when delivered by a pediatric nurse practitioner [34, 52]. These findings are further illustrated in the Value Model [15] which advocates matching care coordinator skillset (RN vs. APRN) to patient/family needs as complexity escalates (Fig.…”

Section: Discussionsupporting

confidence: 80%

“…Activities of APRN care coordinators described elsewhere include acute and chronic condition management, care coordination with providers, parental education and support, care coordination with community resources and discharge planning [29]. Health care teams with APRNs coordinating care for CMC have demonstrated improved outcomes and lower costs, particularly through a reduction in hospital length of stay [30–34]. …”

Section: Introductionmentioning

confidence: 99%

“…Tele-health facilitates clinic-home and clinician-consumer communication and the use of telehealth to support management of chronic health conditions outside clinic visits is expanding [36]. Telephone and video telehealth care management of adults showed improved health outcomes, increased patient satisfaction and reduced costs [37–40], and care coordination for CMC delivered via telephone telehealth showed similar results [31, 32, 34]. …”

Section: Introductionmentioning

confidence: 99%

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Meeting the Needs of Children with Medical Complexity Using a Telehealth Advanced Practice Registered Nurse Care Coordination Model

Cady

Erickson

Lunos

et al. 2014

Matern Child Health J

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Effective care coordination is a key quality and safety strategy for populations with chronic conditions, including children with medical complexity (CMC). However, gaps remain in parent report of the need for care coordination help and receipt of care coordination help. New models must close this gap while maintaining family-centered focus. A three-armed randomized controlled trial conducted in an established medical home utilized an advanced practice registered nurse intervention based on Presler’s model of clinic-based care coordination. The model supported families of CMC across settings using telephone only or telephone and video telehealth care coordination. Effectiveness was evaluated from many perspectives and this paper reports on a subset of outcomes that includes family-centered care (FCC), need for care coordination help and adequacy of care coordination help received. FCC at baseline and end of study showed no significant difference between groups. Median FCC scores of 18.0–20.0 across all groups indicated high FCC within the medical home. No significant differences were found in the need for care coordination help within or between groups and over time. No significant difference was found in the adequacy of help received between groups at baseline. However, this indicator increased significantly over time for both intervention groups. These findings suggest that in an established medical home with high levels of FCC, families of CMC have unmet needs for care coordination help that are addressed by the APRN telehealth care coordination model.

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Section: Discussionsupporting

confidence: 80%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Meeting the Needs of Children with Medical Complexity Using a Telehealth Advanced Practice Registered Nurse Care Coordination Model

Cady

Erickson

Lunos

et al. 2014

Matern Child Health J

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“…41 Programas de melhoria da qualidade em crianças medicamente complexas, focados na capacitação da família e na coordenação Lacerda AF, et al Internamento de crianças com doenças crónicas complexas, Acta Med Port 2019 Jul-Aug;32(7-8):488-498 de cuidados, resultam em redução dos internamentos, da sua duração e da despesa, simultaneamente melhorando os resultados clínicos e a satisfação das famílias. 42,43 Mas é igualmente necessário melhorar a educação dos profissionais, em particular dos internos de Pediatria, sobre o cuidado destas crianças. 17 Também os serviços de adultos devem organizar-se, já que o aumento da sobrevida pode colocar a necessidade de transição de cuidados para os seus serviços, que na maioria das vezes não estão adequadamente preparados.…”

Section: Mas Com Readmissões Frequentes Dependentes Das Necessidadesunclassified

Utilização do Internamento Hospitalar em Portugal Continental por Crianças com Doenças Crónicas Complexas (2011 – 2015)

Lacerda

Oliveira²,

Cancelinha

et al. 2019

Acta Med Port

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Introduction: Due to epidemiological change, interest in complex chronic conditions has been increasing within the pediatric health system. As such, we aim to evaluate hospital inpatient care in the National Health Service (mainland Portugal) by pediatric patients (0 – 17 years) with complex chronic conditions.Material and Methods: Observational longitudinal retrospective epidemiological study using anonymized administrative data. We selected hospitalizations within the pediatric age limit, 2011 – 2015; healthy newborns and radiotherapy outpatients were excluded. A descriptive analysis of the admissions with complex chronic conditions was analysed by number of complex chronic conditions categories and by complex chronic conditions categories. Non-parametric tests were applied to length of stay, expense, and mortality.Results: Out of 419 927 admissions, 64 918 (15.5%) contained at least one complex chronic conditions code. These admissions due to complex chronic conditions represented 29.8% of hospital days, 39.4% of expense and 87.2% of deaths. Compared to those without complex chronic conditions, expense was double (median €1467 vs €745) and mortality 40 times higher (2.4% vs 0.06%). Of these, 46% were planned (no complex chronic conditions 23.2%); 64.8% occurred in group III – IV hospitals (no complex chronic conditions 27.1%). Malignant was the most frequent category (23.0%); neonatal had the highest median length of stay (12 days, 6 – 41), median expense (€3568,929 – 24 602), and number of deaths (43.5% of total).Discussion: As in other developed countries where the number of pediatric admissions is decreasing, in mainland Portugal we found an increase in the proportion of complex chronic conditions admissions, which are longer, costlier and deadlier (trends intensified in the presence of two or more complex chronic conditions categories).Conclusion: Complex chronic conditions are relevant in the activity and costs regarding pediatric hospitalizations in mainland Portugal. Recognizing this and integrating pediatric palliative care from the moment of diagnosis are essential to promote appropriate hospital use, through the development of effective and sustainable alternatives that meet the needs of children, families, and healthcare professionals.

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“…[ 35 ] The purpose of the workshop was not only to increase family functioning but also to improve parental satisfaction. [ 36 ] This study showed that the workshop improved parental health care satisfaction with communication and technical skills and that the parents had high overall satisfaction with the workshop. By emphasizing parental engagement rather than traditional treatments for children with developmental delays, the small-group format of the workshop enabled the parents to share their experiences with others, [ 5 ] receive needed care assistance, [ 37 , 38 ] develop positive partnerships with health care providers and educators, [ 37 ] and increase communication among health care providers, teachers, and other parents.…”

Section: Discussionmentioning

confidence: 92%

Short-term family-centered workshop for children with developmental delays enhances family functioning and satisfaction

Hsieh

Lee

2016

Medicine

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We investigated the clinical efficacy on family functioning and parental satisfaction of a short-term family-centered workshop for children with developmental delays.A total of 32 children with developmental delays and their parents participated in 2-hour weekly group therapy sessions over 6 weeks. The workshop was conducted by rehabilitation professionals and teachers using a family-centered multidisciplinary approach. Both before and after the 6-week workshop, the parents were administered the Pediatric Quality of Life Inventory (PedsQL) Family Impact Module, the PedsQL Healthcare Satisfaction Module, the Hospital Anxiety and Depression Scale, and the World Health Organization Quality of Life brief assessment instrument. Overall satisfaction with the workshop was also evaluated.Significant improvements were noted in physical aspect (P = 0.03), communication (P = 0.002), and daily activities (P = 0.04) in the PedsQL Family Impact Module, and in communication (P = 0.03) and technical skills (P = 0.05) in the PedsQL Healthcare Satisfaction Module. Overall satisfaction with the workshop was rated as very high. There was no significant effect on psychological distress or quality of life.Short-term family-centered workshops for children with developmental delays improved family functioning and the parental perception of satisfaction, including health care satisfaction.

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Development of a Hospital-Based Care Coordination Program for Children With Special Health Care Needs

Cited by 15 publications

References 10 publications

Meeting the Needs of Children with Medical Complexity Using a Telehealth Advanced Practice Registered Nurse Care Coordination Model

Meeting the Needs of Children with Medical Complexity Using a Telehealth Advanced Practice Registered Nurse Care Coordination Model

Utilização do Internamento Hospitalar em Portugal Continental por Crianças com Doenças Crónicas Complexas (2011 – 2015)

Short-term family-centered workshop for children with developmental delays enhances family functioning and satisfaction

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