Family-centered care after pediatric brain injury includes specific communication techniques, capacity building and care coordination

Family-centered care has been linked to improved patient outcomes as well as family and staff satisfaction.

The critical care period after a child suffers a brain injury is incredibly stressful for families. Providers can assist families to understand and engage in the decision making process and care plan by incorporating a family-centered model into their practice. Three over-arching elements of family-centered care include communication, capacity building and care coordination.

Family-centered communication techniques include: being thorough in your explanation, using multiple methods to ensure understanding of injury and care (written, verbal, demonstration, teach-back), utilizing interpreters when needed, providing information in a timely manner, listening to family and answering questions, and providing clear information that prepares families for upcoming decisions and possible outcomes.

Capacity building for providers includes learning to incorporate the family’s culture into your communication style with that family, being aware of power imbalances in provider-family interactions and utilizing a humble stance when employing the communication techniques listed above. Providers can empower families to participate in the child’s care by providing brain injury care training and allowing unrestricted access to the child. Facilities can consider enhancing caregiver physical comfort (comfortable chair, easy access to food and water) and provide practical assistance to those in need (parking payment assistance, travel costs, shelter).

Care coordination requires fostering partnerships with families, including them as part of the interdisciplinary care team and seeking and valuing their input. It also includes collegiality and maintaining good relationships with other providers in the hospital who care for the child. Continuity of information provided to family from different team members is crucial; this often requires increased communication between providers and active collaboration and planning around communication to the family. Focusing on assisting families through transitions of care is also important. Preparing families for the challenges of transitioning to a rehabilitation unit or back to home and school is important. Providing referrals to case management services to assist families in navigating the complicated healthcare system is a key step to a smooth transition. Social workers can be an important partner in these processes.

Conducting family-centered care can improve the family experience of the acute care setting, and their understanding and engagement in care.

References

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Committee on Hospital Care and Institute for Patient-and Family-Centered Care. Patient-and family-centered care and the pediatrician’s role. Pediatrics 2012

Davidson JE, Powers K, Hedayat KM, et al. Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American College of Critical Care Medicine Task Force 2004–2005. Crit Care Med. 2007

American Academy of Pediatrics, Committee on Hospital Care. Family-centered care and the pediatrician’s role. Pediatrics 2003