Why Family-Centered Care Matters

1. Why Family-Centered Care Matters Alejandro Floh MD, MSc. 10th International Conference Pediatric Cardiac Intensive Care Society December 13, 2014

2. Days of Intensive Care Past

4. Unintended Consequences • Stress • Parents • Care providers • Isolation • Child • Health care system • Extended family • Disengagement

5. AAP 2003 Task Force on the Family • The family: • “The most central and enduring influence” • Family not part of interventional unit • Family involvement in decision-making • … systems and practices not organized to support this paradigm Pediatrics 111(6); 6 June 2003:1541-1571

6. Recommendation: Pediatricians should encourage both parents to be involved in the health care of their child Pediatrics 111(6); 6 June 2003:1541-1571

7. Family-Centered Care was born

8. Family-Centered Care – Definition • “… is an approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families. “ • “… recognize the vital role that families play in ensuring the health and well-being” Institute for Patient- and Family-Centered Care

9. Components of Family-Centered Care • Respect • Communication • Collaboration • Participation Frazier A, Frazier H, and Warren NA. Crit Care Nurs Q. 2010 Jan-Mar;33(1):82-6.

10. Family-Centered Care in Current Context • Focused on family presence • Bedside • Procedures1 • Resuscitation2 • Family Support during hospitalization • Sibling Care – play areas • Libraries and resource room 1) Pediatric Emergency Care 2005; 21:787-91 2) Circulation 2000; 102:1-291

12. Family-Perceived Outcomes • Increased time for visitation associated with increase parent satisfaction • Sibling visitation is not harmful and exposed children show fewer negative behaviors • Majority (>75%) of families who attend resuscitation found it to be a favourable experience and assisted in the grieving process Critical Care Medicine 2007; 35:605–622

13. Sick Kids ICU Initiatives– Enhancing Communication Balit C, Hubbert J, Watt C

14. Locally-Derived Solutions

15. Attending Staff Physician Cardiac Critical Care Staff Physician PICU Staff Physician

16. If you need further assistance please contact any of the following: Craig Campbell Senior Manager PICU/ACTS Critical Care Unit Patricia Sutton Senior Manager, Cardiac CCU Cardiac Critical Care Unit Dr Peter Cox, MD FRCPC Associate Chief & Division head Critical Care Unit Dr Steven Schwartz, MD FRCPC Division Head , Cardiac Critical Care Unit Dr Peter C. Laussen, MD BS Chief, Critical Care Medicine Program

17. Complex and Long-stay Patients

18. Measured Outcomes Oriented to Intensive Care Unit Receive consistent messaging

19. Sick Kids ICU Experience – Enhancing Integration Family presence at Nursing Handover • Allowing families to be present at nursing handover • Engage the family in novel way • Increase transparency • Foster communication • Maintain an efficient system that accurately transfers of information, in a confidential setting

20. Child and Family Experience LeBlanc N, McAllister M, Keilty K, McCormick A, Haliburton S.

21. … Advocated by families • … Promoted by administration • … Championed by nursing staff • Transition from a MOVEMENT … • … to a CULTURE

22. Future Directions • Integration across entire health care system • Impact on patient-related outcomes, quality and safety, system efficiency Caution not to abdicate decision-making to parents