
Parent Partnership:
The cornerstone of the medical home
A medical home revolves around a family-professional partnership
that is the foundation for wellness, acute and chronic condition management.
Medical home is not a program adopted by a practice for children with
special health care needs. Although some of the aspects of a medical
home are specifically for children with special health care needs, a
medical home actually represents quality health care that focuses on
family-physician partnerships for all children. "All children deserve
a medical home" is one of the Healthy People 2010 national health
objectives.

Regardless whether a family brings their child to see
a physician for acute health care, preventive care or for management
of a chronic health condition, they want to have a trusting collaborative
relationship with their child’s doctor. This family-professional
partnership should prevail in whatever type of care they are seeking.
This partnership is the foundation of the medical home model. Without
this trusting collaborative partnership, the family does NOT have a
medical home. Beyond this partnership, the medical home model provides
a blue print for practices to incorporate best practice models and evidence-based
medicine as much as possible. This means knowing community resources,
communicating effectively with sub-specialists, implementing professional
policy guidelines like developmental screening, immunization schedules
and Bright Futures
Guidelines in well child care.
Families can be valuable assets when you decide to develop
a formal approach to improving quality in your practice. Seeking input
from families who have a child with special health care needs provides
valuable first-hand experiences that primary care physicians would otherwise
not realize. Practice staff can learn a lot from families when they
engage them in discussing the day-to-day issues, barriers and challenges
they face in caring for and meeting the many needs of their child and
family.
Physicians need to reach out and actively encourage parents
to become “parent partners” with the practice. This can
be done as part of an organized Quality Improvement Team (QIT) or through
family surveys, focus groups or simply through everyday communication
with families. Impromptu communication is a good tool, but planned communication
efforts are more consistent and meaningful over time.
Practices often recognize the value but fail to elicit
family input. Families understand the “little things” that
make a visit to the physician effective and beneficial. This can include
such things as how the practice has trained staff to answer an initial
phone call and how the practice can schedule additional time to treat
children with special health care needs. By asking families “what
could be done better”, or “what can we do to make your appointment
more beneficial”, these simple questions can provide opportunities
for families to help improve the quality of health care delivery within
the practice.
Practices that have incorporated family involvement have seen changes
that have enhanced the quality of care. Numerous practices across Illinois
have made changes as a result of family involvement. Some of these changes
include:
- Use of specific phone scripts at the point of initial contact to
help make the appointment go smoothly for the family. These scripts
often ask for family input on accommodations needed to improve their
visit experience, such as waiting in the waiting room versus being placed
immediately in the exam room.
- Assistance getting into and out of the office, when needed.
- Extended appointment times for children with special health care
needs.
- Routinely asking for family feedback in the form of surveys or questionnaires.
- Providing resources in the practice, like internet access or distributing
specific health related materials.
- Providing parent to parent connections by way of support groups or
after hours informational meetings.
The list can go on and on. The important fact to remember is that these
suggestions require the input of families within your practice to identify
and meet their relative needs. Based on a survey reported by Liptak
and Revell, both parents and physicians were asked what services families
most needed. The following table displays the comparative differences
in priorities between physicians and parents.
Survey Results:
Physicians’ and Parents’ Ranking of Needed Services
Services |
Physicians |
Parents |
| Respite care |
1 |
9 |
| Day care |
2 |
21 |
| Parent support groups |
3 |
3 |
| Help with behavior problems |
4 |
10 |
| Financial information or help |
5 |
2 |
| After-school child care |
6 |
20 |
| Assistance with physical household changes
|
7 |
15 |
| Vocational counseling |
8 |
6 |
| Psychological services |
9 |
5 |
| Homemaker services |
10 |
22 |
| Recreational opportunities |
13 |
4 |
| Information about community resources |
14 |
1 |
| Dental treatment |
16 |
8 |
| Summer camp |
19 |
7 |
Families who participated in the survey listed "information about
community resources" as the number one need whereas physicians listed
"respite care". Families focused on information and the physicians
on services. The important point to remember is that without family involvement,
a practice may focus on changes that represent different priorities than
those of the parents they serve.
Why is family involvement the cornerstone of the Medical Home in your
practice? Because each partner - the family, the primary care provider
and other office staff - brings their unique perspective to the process.
Each partner has important viewpoints to contribute to the process, so
each has uniquely meaningful ways to enhance the delivery of quality health
care.
Unity is strength... when there is teamwork and
collaboration, wonderful things can be achieved.
Mattie Stepanek
Alone we can do so little; together we can do so
much.
Helen Keller
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