Family-Centered Care:Exemplars from Interprofessional Team Experiences

• Claudia Grauf-Grounds, PhD, Licensed Marriage & Family Therapist, Professor Emerita, Seattle Pacific University, Seattle, WA

• Alan Lorenz, MD, Physician, Rochester Institute of Technology, Rochester, NY

• Mary Talen, PhD, Licensed Psychologist, Director Primary Care Behavioral Health, Northwestern Family Medicine Residency, Chicago, IL

• Tina Schermer Sellers, PhD, Licensed Marriage & Family Therapist, Associate Professor, Seattle Pacific University, Seattle, WA

Session # A3a

CFHA 20th Annual ConferenceOctober 18-20, 2018 ∙ Rochester, New York

Faculty Disclosure

The presenters of this session have NOT had any

relevant financial relationships during the past 12

months.

Conference Resources

Slides and handouts shared in advance by our Conference Presenters are available on the CFHA website at http://www.cfha.net/?page=Resources_2018

Slides and handouts are also available on the mobile app.

Learning Objectives

At the conclusion of this session, the participant will be able to:

• Describe how interprofessional teams can improve clinical outcomes

• Identify how interprofessional teams can be used throughout the lifespan

• Build bridges with other professionals to increase effective care

Learning Assessment

A learning assessment is required for CE credit.

A question and answer period will be conducted

at the end of this presentation.

Working & playing as a team: some research

Huddle and re-huddle…..

Start young…..

Know your distinct skills and knowledge…..

Be flexible on “who” calls the plays (flexible leadership)....

Outcomes when teams work well

More “wins”…a patient/family collaborates more with care

Less “injuries”.....less provider burn-out

Less frustration...complex issues managed better

Exemplar 1: Well Child Check-ups

• Well-child check-ups were designed for inoculating children against physical disease

• Challenged with inoculating children and families with the "antibodies" for psycho/social/emotional risks.

Standard vs. Upgraded Protocols

Standard Well Child Exams

• Immunizations

• Monitor physical growth

• Early detection of disease,

• Safety and injury prevention (e.g. poison, locks, car seats)

• Anticipatory guidance: eating, sleeping, discipline

WCC-Updated• Biopsychosocial Assessments

• AGES and STAGES (ASQ)

• A: Affection: • Reading, singing, rocking, playing• Self-soothing strategies, emotional regulation

• B: Behavior Management: • Tantrums, Self-control/emotional regulation • Toilet Training

• C: Cognitive: Developmental Teaching• 30 Million Words• Developmental toys-games

• Parental regulation-engagement

• Community Context (violence, resources)

Video: Integrating Bio-Medical-Psycho-social

Work flow and Team members

Check-In: ASQ

Well Child Assessment

Exam

Parent-child Developmen

tal interaction

Provider-Behavioral

Health-Parent

Referrals and Follow-

up

Exemplar 2: A university student

Does this have special meaning for you?

Normal Exam

Danger

Normal Schedule

Regular Exam Room

Patient provides verbal consent to be interviewed and examined by psychological professional in training

Introductions

Cold/Warm/Hot Handoffs

Exemplar 3: Cancer & end-of-life care

- Beliefs of patient made it

impossible for MD to provide

end of life care

- Advancing condition added

urgency

- Need of community and

family added urgency

- MedFT asked to solve the

“problem”

CFHA: Spring training for professionalsWhat we have learned here

Adequate preparation and sharing expectations

Doing introductions all around...it’s all about relationship!

Offering feedback

Staying aware of inherent power differentials, and maintaining a flexible hierarchy

Q & A

1. Fiscella, K. & McDaniel, S.H. (2017). The complexity, diversity and science of primary care teams. American Psychologist 73(4), 451-467.

2. Brown, J.B., Hutchison, B., Ryan, B.L., Thorpe, C., & Markle, E.K.R. (2015). Measuring Teamwork in Primary Care: Triangulation of Qualitative and Quantitative Data. Family Systems & Health, 33(3), 193-202.

3. Dongen, J.J., Habets, I.G.J., Beurskens, A., & Bokhoven, M.A. (2017). Successful participation of patients in interprofessional team meetings: A qualitative study. Health Expectations, 20(4), 724-733.

4. Ulrich, B., & Crider, N.M. (2017). Using teams to improved outcomes and performance. Nephrology Nursing Journal, 44(2), 141-151.

References

References5. Cote, G., Lauzon, C., & Kyd-Stirckland, B. (2008). Environmental scan of interprofessional collaborative practice initiatives. Journal of interprofessional care. 22(5), 449-460.

6. Abrahamsen, C., Norgaard, B., Drabord, E. & Nielsen, D. (2017). Reflections on two years after establishing an orthogeriatric unit: a focus group study of healthcare professionals’ expectations and experiences. BMC Health Services Research, 17, 1-9.

Session Evaluation

Use the CFHA mobile app to complete the

evaluation for this session.

Thank you!