Cady Rhonda G, Belew John L
Gillette Children's Specialty Healthcare, St. Paul, MN, 55101 USA.
Children (Basel). 2017 Jun 6;4(6):45. doi: 10.3390/children4060045.
The overarching goal of care coordination is communication and co-management across settings. Children with medical complexity require care from multiple services and providers, and the many benefits of care coordination on health and patient experience outcomes have been documented. Despite these findings, parents still report their greatest challenge is communication gaps. When this occurs, parents assume responsibility for aggregating and sharing health information across providers and settings. A new primary-specialty care coordination partnership model for children with medical complexity works to address these challenges and bridge communication gaps. During the first year of the new partnership, parents participated in focus groups to better understand how they perceive communication and collaboration between the providers and services delivering care for their medically complex child. Our findings from these sessions reflect the current literature and highlight additional challenges of rural families, as seen from the perspective of the parents. We found that parents appreciate when professional care coordination is provided, but this is often the exception and not the norm. Additionally, parents feel that the local health system's inability to care for their medically complex child results in unnecessary trips to urban-based specialty care. These gaps require a system-level approach to care coordination and, consequently, new paradigms for delivery are urgently needed.
护理协调的总体目标是跨机构进行沟通与共同管理。患有复杂疾病的儿童需要多种服务和提供者的护理,护理协调对健康和患者体验结果的诸多益处已有记录。尽管有这些发现,但家长们仍表示他们面临的最大挑战是沟通差距。出现这种情况时,家长要负责汇总并在不同提供者和机构之间共享健康信息。一种针对患有复杂疾病儿童的新型初级-专科护理协调合作模式致力于应对这些挑战并弥合沟通差距。在新合作关系的第一年,家长们参加了焦点小组,以更好地了解他们如何看待为其患有复杂疾病的孩子提供护理的提供者和服务之间的沟通与协作。我们从这些会议中得出的结果反映了当前的文献,并从家长的角度突出了农村家庭面临的其他挑战。我们发现,家长们对提供专业护理协调表示赞赏,但这往往是例外而非常态。此外,家长们认为当地卫生系统无法照顾他们患有复杂疾病的孩子,导致他们不得不前往城市的专科护理机构,徒增不必要的行程。这些差距需要系统层面的护理协调方法,因此,迫切需要新的服务提供模式。