What does it take to create and implement an effective, family-centered plan of care for a child with special health care needs? In this webinar, two expert speakers discussed their approaches to the process of care planning in two very different settings—Children's Hospital of Philadelphia and a small private practice in Vermont.
Measuring Family Experience of Care Integration to Improve Care Delivery LucilePackardFoundation
The family perception of care integration is essential in identifying opportunities to improve processes of care coordination and care management. This June 15 webinar introduced the Pediatric Integrated Care Survey (PICS), a validated instrument developed by Richard Antonelli, MD, MS, Medical Director of Integrated Care at Boston Children's Hospital, and his team. The instrument assesses family experience of care integration. It asks family respondents to identify the members of their child's/youth's care team and report on their experiences with integration across disciplines, institutions, and communities.
Effective care coordination ranks high on the priority list of families of children with special health care needs, yet it remains an elusive goal for most. This webinar featured a parent's perspective, along with real-life examples from a provider and a payer on how to develop effective local care coordination systems. The webinar, which drew close to 400 registrants from across the US, was designed as a first step in building a national movement to promote care coordination policies and payment options that better serve children, families, and care providers.
Measuring Family Experience of Care Integration to Improve Care Delivery LucilePackardFoundation
The family perception of care integration is essential in identifying opportunities to improve processes of care coordination and care management. This June 15 webinar introduced the Pediatric Integrated Care Survey (PICS), a validated instrument developed by Richard Antonelli, MD, MS, Medical Director of Integrated Care at Boston Children's Hospital, and his team. The instrument assesses family experience of care integration. It asks family respondents to identify the members of their child's/youth's care team and report on their experiences with integration across disciplines, institutions, and communities.
Effective care coordination ranks high on the priority list of families of children with special health care needs, yet it remains an elusive goal for most. This webinar featured a parent's perspective, along with real-life examples from a provider and a payer on how to develop effective local care coordination systems. The webinar, which drew close to 400 registrants from across the US, was designed as a first step in building a national movement to promote care coordination policies and payment options that better serve children, families, and care providers.
Behavioral Health Staff in Integrated Care SettingsCHC Connecticut
Webinar broadcast on Feb 27, 2019 - 3:00PM EST
Delivering behavioral health services as a part of an integrated team is crucial to providing comprehensive primary care services. Focusing on the vital role of behavioral health, experts will share the key elements that maximize the contributions of these team members through structured approaches to screening, the use of “warm hand offs” to ensure connection to primary care, and implementing a robust group of treatment programs to enhance access and improve outcomes. This session will also discuss the day-to-day operation of a behavioral health program and detail the data and clinical dashboard that supports the work of these vital team members. There has been tremendous progress from health centers across the country in the integrating behavioral health, this webinar will share how integrated behavioral health can advance the team’s capability to provide effective and high quality care to complex patient populations.
Developments in Urgent Care Services: Children and Young People's Mental Heal...NHSECYPMH
This presentation goes through the urgent care work that has been achieved within CYPS in TEWV and further developments in urgent care mental health services for young people and their families.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Mental Health and Addictions Services relocated one staff position to the primary health site in Meadow Lake to be able to provide just in time service to patients who may need information, support, brief intervention or a referral for more in depth services.
Better Health
Mary Rowland; Annette Viljoen
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance. Many positions in primary care now require QI training as part of employees' professional development.
Our expert faculty discuss tools you can use to build and implement a QI infrastructure within your team-based setting to improve patient care.
Panelists:
• Deb Ward, RN, Senior Quality Improvement Manager, Community Health Center, Inc.
• Kathleen Thies, PhD, RN, Consultant, Researcher, Weitzman Institute
2.5 Partnership working - Anne Forletta, Katherine HewittNHS England
Partnership working. Building partnerships with acute hospitals, voluntary and community services. Featuring examples from Birmingham and Coventry. Anne Forletta, My Healthcare Birmingham; Katherine Hewitt, Gateway Family Services, Birmingham.
Developing a Postdoctoral Psychology Residency Program in Your Community Heal...CHC Connecticut
Two years later, we continue to witness the pandemic’s toll on mental health – and a sustained increased demand for mental health services. Behavioral health care providers who are experienced in integrated care settings are needed now more than ever.
Join this webinar to learn how your health center can establish its own postdoctoral clinical psychology residency program.
This webinar will address considerations such as program structure, design, curriculum, the supervisor’s role, required resources, and the benefits of sponsoring an in-house formal postdoctoral clinical psychology residency training program.
Panelists:
• Dr. Tim Kearney, Chief Behavioral Health Officer, Community Health Center, Inc.
• Dr. Chelsea McIntosh, Training Director, CHC Postdoctoral Residency Program, Community Health Center Inc.
The Next Steps to Improving Home Health Care for Children with Medical Comple...LucilePackardFoundation
This briefing on family needs for home health care and potential workforce and policy solutions featuring the perspectives of a parent advocate, a home health care administrator, a pediatrician, and a state official.
Behavioral Health Staff in Integrated Care SettingsCHC Connecticut
Webinar broadcast on Feb 27, 2019 - 3:00PM EST
Delivering behavioral health services as a part of an integrated team is crucial to providing comprehensive primary care services. Focusing on the vital role of behavioral health, experts will share the key elements that maximize the contributions of these team members through structured approaches to screening, the use of “warm hand offs” to ensure connection to primary care, and implementing a robust group of treatment programs to enhance access and improve outcomes. This session will also discuss the day-to-day operation of a behavioral health program and detail the data and clinical dashboard that supports the work of these vital team members. There has been tremendous progress from health centers across the country in the integrating behavioral health, this webinar will share how integrated behavioral health can advance the team’s capability to provide effective and high quality care to complex patient populations.
Developments in Urgent Care Services: Children and Young People's Mental Heal...NHSECYPMH
This presentation goes through the urgent care work that has been achieved within CYPS in TEWV and further developments in urgent care mental health services for young people and their families.
Improvement Story session at the 2013 Saskatchewan Health Care Quality Summit. For more information about the summit, visit www.qualitysummit.ca. Follow @QualitySummit on Twitter.
Mental Health and Addictions Services relocated one staff position to the primary health site in Meadow Lake to be able to provide just in time service to patients who may need information, support, brief intervention or a referral for more in depth services.
Better Health
Mary Rowland; Annette Viljoen
Webinar on Quality Improvement Strategies in a Team-Based Care Environment CHC Connecticut
Building a quality improvement (QI) infrastructure within team-based care is an organizational strategy that will establish a culture of continuous improvement across departments and improve quality in all domains of performance. Many positions in primary care now require QI training as part of employees' professional development.
Our expert faculty discuss tools you can use to build and implement a QI infrastructure within your team-based setting to improve patient care.
Panelists:
• Deb Ward, RN, Senior Quality Improvement Manager, Community Health Center, Inc.
• Kathleen Thies, PhD, RN, Consultant, Researcher, Weitzman Institute
2.5 Partnership working - Anne Forletta, Katherine HewittNHS England
Partnership working. Building partnerships with acute hospitals, voluntary and community services. Featuring examples from Birmingham and Coventry. Anne Forletta, My Healthcare Birmingham; Katherine Hewitt, Gateway Family Services, Birmingham.
Developing a Postdoctoral Psychology Residency Program in Your Community Heal...CHC Connecticut
Two years later, we continue to witness the pandemic’s toll on mental health – and a sustained increased demand for mental health services. Behavioral health care providers who are experienced in integrated care settings are needed now more than ever.
Join this webinar to learn how your health center can establish its own postdoctoral clinical psychology residency program.
This webinar will address considerations such as program structure, design, curriculum, the supervisor’s role, required resources, and the benefits of sponsoring an in-house formal postdoctoral clinical psychology residency training program.
Panelists:
• Dr. Tim Kearney, Chief Behavioral Health Officer, Community Health Center, Inc.
• Dr. Chelsea McIntosh, Training Director, CHC Postdoctoral Residency Program, Community Health Center Inc.
The Next Steps to Improving Home Health Care for Children with Medical Comple...LucilePackardFoundation
This briefing on family needs for home health care and potential workforce and policy solutions featuring the perspectives of a parent advocate, a home health care administrator, a pediatrician, and a state official.
Going Where the Kids Are: Starting, Growing, and Expanding School Based Healt...CHC Connecticut
Webinar broadcast on: June 28 | 3 P.M. EST
This webinar will address the benefits, challenges, and strategic advantages of a school based health center program from a clinical, data, quality, operational viewpoint, communications, and community engagement perspective. Experts will share the strategy for integrating oral health and behavioral health to ensure the best outcomes for patients.
A Conversation on Models of Care Delivery for Children with Medical ComplexityLucilePackardFoundation
Improvements in care delivery for children with medical complexity are becoming a major focus of national and local health care and policy initiatives. A number of new models have been developed, with promising examples of enhanced care coordination and family engagement. The lead author and experts in the field discussed the article, Models of Care Delivery for Children with Medical Complexity.
Improving children and their families experience of the cancer care pathwayUCLPartners
Presentation by Zoe Berger, Joint Chair of the London Cancer Patient Experience Sub Group, at the Teenager and Young Adults Study Day, held on 25 July 2013.
A Conversation on Supporting Self-Management in Children and Adolescents with...LucilePackardFoundation
While self-management support has been a component of adult chronic care for decades, it is just emerging as a critical need for children, especially those with complex conditions. Self-management is a shared undertaking between the child, their parents and care providers, and must take into account the child’s developmental status and the family’s capacities. Clinicians need routine, standardized approaches and tools to address the unique needs of children and their families including assessing self-management skills, collaboratively setting goals, and promoting competence and autonomy in youth.
EOA2016: Connecting Community to the Delivery System PublicPIHCSnohomish
During the last breakout session of the day, at Edge of Amazing 2016, a panel came together to discuss the interdependencies that are not the responsibility of any single organization, but are required if we want to achieve population health. They featured the many ways community is linking to the delivery system, including an overiew of the Plan for Improving Population Health and the Practice Transformation Support Hub.
Mary Beth Brown, WA State DOH
Maria Courogen, WA State DOH
Dr. Gary Goldbaum, Snohomish Health District
Linda McCarthy, Mt. Baker Planned Parenthood
Building Effective Partnerships Between Pediatrics and Public HealthPractical Playbook
The webinar, titled “Building Effective Partnerships between Pediatrics and Public Health: Lessons Learned from the Practical Playbook and American Academy of Pediatrics,” is helpful to anyone interested in learning about partnerships between primary care (especially pediatricians!), public health, and communities.
The webinar includes:
The WHY of partnering: Drs. Dougé and Castel will share their perspectives on why pediatricians should partner with public health.
The HOW: Practical Playbook project planner Tia Simmons will share tools and resources pediatricians, public health professionals, and communities can use to partner and work together.
How can front-line professionals incorporate the emerging brain health ...SharpBrains
(Session held at the 2014 SharpBrains Virtual Summit; October 28-30th, 2014)
12:30-2pm. How can front-line professionals incorporate the emerging brain health toolkit to their practices?
- Elizabeth Frates, Director of Medical Student Education at the Institute of Lifestyle Medicine
- Dr. Catherine Madison, Director of the Ray Dolby Brain Health Center at California Pacific Medical Center
- Barbara Van Amburg, Chief Nursing Officer at Kaiser Permanente Redwood City
- Dr. Wendy Law, Clinical Neuropsychologist at Walter Reed National Military Medical Center
- Chair: Dr. Michael O’Donnell, Editor-In-Chief of the American Journal of Health Promotion
Learn more here:
http://sharpbrains.com/summit-2014/agenda/
iHV regional conf: Theresa bishop - Strengthening Health Visiting into the fu...Julie Cooper
Presentation by Theresa Bishop at the Institute of Health Visiting Regional Professional Conferences 2015.
Theresa Bishop is Professional Lead for Health Visiting for Warwickshire.
Preventing Unintended Pregnancy Among Adolescents: Using mHealth to Promote a...YTH
Health-E You/Salud iTu is an mHealth contraceptive decision support tool for adolescent girls. Through an interactive, youth-centered approach, the App provides accurate information (that can be updated in real-time), individually tailored feedback/messages, and a user-driven experience. Based on the youth’s preferences, and experiences, the App provides contraceptive recommendation(s) while also presenting the youth with all of the possible options including videos of providers and youth. Youth can then share information from the App with their provider to help them communicate their needs, interests and questions. In turn, the provider is better prepared for the face-to-face encounter. Pilot testing shows it is feasible to implement, acceptable to adolescents and providers; improves health knowledge; and visit quality. It is being evaluated at 14 school-based health centers using a longitudinal, cluster randomized control trial research design.
iHV regional conf: Theresa Bishop - Strengthening Health Visiting into the fu...Julie Cooper
Presentation by Theresa Bishop at the Institute of Health Visiting Regional Professional Conferences 2015.
Theresa Bishop is Professional Lead for Health Visiting in Warwickshire.
Improving Discharge Care for Children with Special Health Care Needs through...LucilePackardFoundation
Being discharged from the hospital is a vulnerable time for families and caregivers of children with special health care needs (CSHCN). Appropriate resources and support are essential for care at home and can prevent complications or readmission. The California-based Nurse-led Discharge Learning (CANDLE) Collaborative brings together interdisciplinary clinicians to improve discharge care delivery for CSHCN. Learn about two new discharge practices: closed-loop medication reconciliation and tailored medication teaching, and multidisciplinary discharge rounds with early discharge notification. Speakers share how these innovative practices can be integrated into existing clinical workflows.
Kidsdata.org recently compiled data on Safeguards for Youth to highlight important protective factors and supportive services for California children. Learn about the Safeguards for Youth framework and where to easily access these data. Also, hear from a specialist at the Child Abuse Prevention Center about adopting a prevention mind-set and using trauma-informed practices to address adversity among children. Speakers will be available for questions immediately after the 30-minute briefing.
Stories from the Field: Building a Transformative Partnership with Families a...LucilePackardFoundation
Family-professional partnerships help ensure health care programs and policies are appropriate and well-utilized. While including parents as equal members of their child’s care team is an accepted standard for pediatric care, the core principles of family engagement have not been widely adopted as drivers of health care systems improvement. Hear from two statewide projects – a parent leadership training program and a hospital learning collaborative – that are integrating families as equal partners in addressing system issues. They discuss what it really takes to foster an effective and sustainable collaboration.
Mental Health Policy Briefing: Raising the Priority of California Children wi...LucilePackardFoundation
Mental health services and supports for children with special health care needs (CSHCN) must be a priority for California. This briefing will provide an overview of the mental health services to which CSHCN are entitled, highlight current state policy priorities, and share ways to engage in advocacy efforts. Speakers will be available after the briefing for questions.
Maximizing System-Level Data to Address Health and Social Complexity in ChildrenLucilePackardFoundation
An innovative methodology using system-level data to identify children with health complexity, that is based on medical and social complexity, is transforming how they consider improving quality of care in Oregon. Learn about this new standardized approach, developed by the Oregon Pediatric Improvement Partnership and Oregon Health Authority, and how it has helped inform priority areas, potential policy improvements, investments and partnerships in support of children with health complexity.
Identifying and Serving Children with Health Complexity: Spotlight on Pediatr...LucilePackardFoundation
Children with health complexity face unique medical and social factors that impact their health and engagement of health care services. Health systems play an important role in addressing both factors to build health and resilience. Speakers will share their approach to using system and practice-level data to better identify appropriate care coordination and health management supports for these children. We will also spotlight how this approach was implemented in Kaiser Permanente Northwest through the Pediatric Care Together complex health management program.
Proposed changes in health care payment, from fee-for-service to alternative, risk-sharing payment models, can have a substantial impact on health services for children, especially those with complex care needs. In addition, tying payment to value can increase use of ambulatory and preventive services and encourage creative outreach. However, abrupt changes can interrupt continuity and reduce access to care.
A Conversation on Ethical Considerations for a Fair and Effective Health Care...LucilePackardFoundation
What ethical considerations should guide the design and evaluation of systems of care for children with medical complexity? There are inevitable tradeoffs that any complex health care system must confront when attempting to achieve multiple worthy goals, from benefitting individual patients and families and securing fair distribution of benefits across populations, to operating in a manner that is transparent and free from conflicts of interest.
A Conversation on Protecting Rights of Children with Medical Complexity in an...LucilePackardFoundation
Sufficient access to services for children with medical complexity varies considerably by state, geographic region, and payer. Families, advocates, and health care professionals need to understand children’s rights. Policymakers and payers must help support reliable and appropriate coverage and benefits. Learn how medical-legal partnerships and other forms of advocacy can protect the rights of children and support families in an era of cost containment.
A Conversation on Care Coordination for Children with Medical Complexity: Who...LucilePackardFoundation
Care coordination is an important approach to addressing the fragmented care that children with medical complexity often encounter. What are optimal care coordination services? How does care coordination intersect with care integration and case management? Learn best practices and how to implement a process that will achieve improved outcomes and value for children with special health care needs and their families.
A Conversation on Meaningful Family Engagement, from Clinical Care to Health ...LucilePackardFoundation
Engaging with families is vital to transforming the health care system and positively impacting the life course of vulnerable populations. Families have extensive experience in partnering with professionals to improve systems of care, are organized and connected across the country, and stand ready to assist at every level of next efforts for improvement. Learn how to meaningfully involve families at every level of health care systems and engage them as critical partners in designing policies that will improve care for all children.
Increased attention to children with medical complexity has occurred because these children are growing in number, consume a disproportionate share of health-system costs, and require policy and programmatic interventions that differ in many ways from the broader group of children with special health care needs. But will this focus on complex care lead to meaningful changes in systems of care and outcomes for children with serious chronic diseases?
As health care and financing systems become more sophisticated, health care systems are increasingly using a process known as "risk tiering" to group patients with similar degrees of need for health care and care coordination services. Families and care providers of children with chronic and complex conditions should understand the risk tiering process, as it may affect access to services these children need.
Childhood adversity, such as child abuse and exposure to violence and poverty, can have negative long-term impacts on health and well being. In this webinar, our panelists discussed how to describe the burden of childhood adversity in your community, how to frame your message most effectively, and how to engage and mobilize your community to address the roots and effects of childhood adversity. Panelists also lead participants on a virtual tour of Kidsdata’s Childhood Adversity and Resilience data, research, and policy recommendations.
CA Senate Select Committee on CSHCN Presentation: Systems Overview 12/1/15LucilePackardFoundation
Physical, mental, and developmental health, along with education, were the topics at the December 1 inaugural hearing of a newly established Senate Select Committee on Children with Special Needs. The purpose of the committee is to increase legislators' understanding of how programs and services for children with special needs are organized and delivered, and to identify ways to improve and strengthen the systems. The initial meeting presented an overview of the various systems and how they interact. Representatives from each field, as well as parents and government officials, provided testimony.
This presentation provides an overview of the systems that serve children with special health care needs in California.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Beyond Checklists: Care Planning for Children with Special Health Care Needs – Webinar November 9, 2016
1. Beyond Checklists: Care Planning for
Children with Special Health Care Needs
Wednesday, November 9, 2016
10-11 a.m. PT, 1-2 p.m. ET
Sponsored by
Lucile Packard Foundation for Children's Health
Catalyst Center
Family Voices
3. MODERATOR
Jeanne W. McAllister, BSN, MS, MHA
Associate Research Professor of
Pediatrics
Indiana University School of Medicine,
Children's Health Services Research
Division
4. HOUSEKEEPING
• Please enter questions into the GoToWebinar chat
box.
• All attendees will be muted for the duration of the
webinar.
• Webinar recording and slides will be posted on the
Foundation website and shared with all registrants.
5. Jill S. Rinehart, MD, FAAP
Partner, Hagan, Rinehart &
Connolly Pediatricians, PLLC, and
Clinical Associate Professor of
Pediatrics at the University of
Vermont College of Medicine
PANELISTS
Annique K. Hogan, MD
Medical Director of the CHOP
Compass Care program and the
Integrated Care Service,
Children’s Hospital of
Philadelphia
6. Primary Care of the Medically Fragile NICU
Graduate
Care Planning for Children with
Special Health Care Needs
Annique K. Hogan, MD
Medical Director, CHOP Compass Care
Medical Director, Integrated Care Service
Children’s Hospital of Philadelphia
7. Context: Tertiary Care Complex Care Program
• CHOP Compass Care:
– Tertiary Care/Consultant Model
– Medically Complex and Fragile Patients:
• 3 or more complex chronic conditions
• Multiple subspecialists
• Multiple admissions and/or ED visits
– Ambulatory and Inpatient
– Multi-disciplinary:
• Physicians, Nurse Practitioners, Nurse Coordinators,
Social Work, Administrative
8. Goals of the Care Plan
• Articulate and Communicate
Patient/Family Concerns and
Goals
• Provide a Concise Medical
Summary
• Communicate Problem-Based
Plans
• Provide Contingency Plans
• Clarify Care Team and Roles
9.
10.
11. Target Audience for Care Plan
• Patient/Family
• Care Team
• Other Healthcare Providers (determined by
patient/family)
– Emergency Department/Urgent Care
– Inpatient
– Home/School Providers
12. Pre-Work
• Chart Review
– Abstract
– Problem List
– Specialty/Primary Care Visits
– Hospitalizations/ED Visits
– Upcoming Events
• Care Team
• Completed by Care
Coordinators
14. Care Team and Roles
• Determine members of the
Care Team
• Roles of each member
– Core team or Advisory team
– Which problems and which
medications
• Missing pieces
15. Concise Summary
• Consistent Documentation and Collaborative
Approach
– “Smart phrases”
– Multi-disciplinary team contributions
• Problem-Based Approach
– Designated care team member(s)
– Relevant history
– Current status
– Associated medications
16. Key Information
• Current Feeds
– Who is managing
– Regimen
– Feeding Tube
• Current Medications
– Dose
– Route
• Home Care, Nursing,
Therapies, School
17. Developing the PLAN within the Care Plan
• Collaborative
• Problem-Based
• Upcoming Planned Events
• Contingency Planning
• Communication Planning
• Scheduling
• Shared and Refined
18. Documenting the Care Plan
• Visit Encounter Letter
• Beyond the visit note
– Longitudinal Plan of Care (LPOC)
19. Sharing the Care Plan – Accessibility
• EHR Tools
– Example: Epic
Longitudinal Plan of
Care (LPOC)
– Patient portal
• Letter
– Available to family and
care team members
20. Implementing the Care Plan
• Post-Visit Communication
– Within the Care Team
– With the Patient/Family
• Scheduled Telephone Calls
• Inpatient to Outpatient
– Facilitate Communication
– Update Care Plan
• Routine Scheduled Follow-Up Visits
21.
22. Team approach
• All members of the team contribute to
creating, maintaining, and implementing the
Care Plan
24. Jill S. Rinehart, MD, FAAP
Partner, Hagan, Rinehart & Connolly Pediatricians, PLLC, and
Clinical Associate Professor of Pediatrics at the University of
Vermont College of Medicine
25. Pediatric Care Coordination Learning Collaborative
Following the guidelines of the
Lucile Packard Foundation’s
“Achieving a Shared Plan of
Care Implementation Guide”
Purpose
Plan, implement and evaluate the
impact of effective care coordination
by working with
• Vermont’s primary and specialty
health care professionals
• Patients and their families
• Community-based, child-serving
agencies and organizations
Achieving a Shared Plan of Care
26. Pediatric Care Coordination Participating
Practices
Central Vermont
Little Rivers Health Care, Bradford & Wells
River
South Royalton Health Center, South
Royalton
Associates in Pediatrics* - Berlin, Berlin
Associates in Pediatrics* - Barre, Barre
Middlebury Pediatric & Adolescent Medicine
Mt. Ascutney Hospital & Health Center, Windsor
Rainbow Pediatrics, Middlebury
Northeastern Vermont
St. Johnsbury Pediatrics, St. Johnsbury
Middlebury
Burlington
Barre
Wells River
St. Johnsbury
Rutland
Bennington
South Royalton
Bradford
Northwestern Vermont
Hagan, Rinehart & Connolly Pediatricians,
Burlington
Timber Lane Pediatrics, Burlington
Timber Lane Pediatrics, South Burlington
UVMMC Pediatrics, Burlington
Southern Vermont
Green Mountain Pediatrics, Bennington
Brattleboro Primary Care, Brattleboro
Maplewood Family Practice, Brattleboro
Community Health Centers of Rutland Regional, Rutland
Just So Pediatrics, Brattleboro
Family Medicine Associates, Springfield
Springfield
Brattleboro
Windsor
Berlin
27. Independent Practice
• Three pediatricians: Dr.
Hagan, Dr. Rinehart, Dr.
Connolly
• Three pediatric nurse
practitioners
• One main RN Care
Coordinator ~4000 active
patients
• Insurance mix: 35% Medicaid,
60% private ,<5% uninsured
28.
29. 30
Where to Start?
Shared Care Planning Can Begin
with: Family, Patient, Community
Partner, or Health Care
Professional
30. Comprehensive Understanding
Harper Browne, C. (2014, September). The Strengthening Families Approach and Protective Factors Framework:
Branching out and reaching deeper. Washington, DC: Center for the Study of Social Policy
33. Pre-Visit Planning
Before you enter the room… • Share recent, relevant information
• Screening tests (ACT, PHQ9)
• An agenda from the family for
today’s visit
• Labs, radiology, specialist visit
reports
• Follow up from community
members
34
34. Care Mapping
Informal Supports
Extended Family
Friends
Groups
Cultural Supports
Religious Organizations
Clubs
Recreation
Sports
Camps
Community and State
Services
CSHCN
Parent to Parent Org.
Economic Services
Developmental Services
Mental Health
Early Intervention
Home Health Services
Children’s Palliative Care
Child Protection
WIC
Private Therapists
Personal Care Services
School
Teachers
IEP Case Manager
Speech
PT/OT
School Nurse
Other Services
Medical
Specialists
Sub-specialists
Dental Care
Financial Supports
Insurance
Respite
Childcare Subsidy
Economic services
Social Security
Food Subsidy
Employment
Community Grants
Medical Home
Primary Care Provider
Care Coordinator
Childcare
Teachers
Afterschool Care
37. VG
CG
5 yo
7 yo4 yo
Hagan, Rinehart
and
Connolly
Pediatricians
Shelburne
Community
School
Special
Educator
Speech Language
Pathologist
School Physical
Therapist
Occupational
Therapist
Swimming
at YMCA
Rue
Kendrick-
classroom
teacher
PCA
Debbie-
Para-professional
S.&J.,
MGM
friends
(service dogs in training)
Petsmart
Therapy Dogs
of Vermont
Dr. Hastings-
Peds-Ophthalmology
Dr. Benjamin-
physiatrist
Dr. D'Amico-
Gastroenterologist
Dr. Filiano-
Neurologist at
Dartmouth
Dr. Bauer-
Peds Neurosurgeon at
Dartmouth
Dr. Tranmer-
Neurosurgeon
CSHN Registered
Dietitian
Apria
Medical Store
Keen Medical
Biomedic Appliances
CSHN Social
Worker
Howard
Center
Deborah Keel- Flexible
Family FundingDelana-
BRIDGE
Shelburne Community
School
Shelburne
Nursery
School
Community Alliance
Church in Hinesburg
Children's Ministry
Outings- Sugar House,
Echo, Lowes, town
activities, swimming
etc.
Section 8 Housing
Wheels for Johnny-
Fundraiser for
handicap accessible
vehicle
SSI
SSA
PSE
Child Only Reach Up
Grant
3 Squares Vermont
Champlain College-
Healthcare Technology
Garrison, Victoria . Interview by Marley Donaldson. Personal interview. 26 Mar. 2013.
Medical
Family
State/Education/
Community
38. Benefits to Clinicians
• Don’t have to have all of the
solutions
• Part of a collaborative team
• More time for medical
thinking and deeper
understanding of situation
• Improved clinical outcomes
• Feel better prepared
• Less time spinning wheels
• More time discussing the
important issues and not
“catching up”
• Less phone time
39
39. Key to Family Engagement
• Build trusting relationships
• Allows for timely, accurate information sharing
• And…
40. …Problem Solving Discussions
• Each of us has a piece of the puzzle
• Keeping an open mind
• Getting from A to B may require
going to C and D first
• Patience
• Kindness
• Humility
• Parking Lot and follow up
41. Care Conferences
• Introductions/Contacts
• Set Agenda
• Set Roles: Facilitator
• Start with Strengths
• Care Map
• Discussion
• Minutes Recorded
• Update Plan with Next Steps & Accountability
• Next Care Conference Date (if needed)
• Care plan is shared at end of meeting
45. Cultural Humility
“Cultural humility acknowledges that it is
impossible to be adequately knowledgeable
about cultures other than one's own…
Cultural humility requires us to take
responsibility for our interactions with
others beyond acknowledging or being
sensitive to our differences.”
46. LEARN
• Listen: to the person’s perception
• Explain: your perception
• Acknowledge: similarities & differences
• Recommend: both have ideas on what to do
• Negotiate: make a plan WITH (not for) the
family
(adapted from Berlin & Fowkes, 1982)
47. Kleinman’s Questions (1980)
• What do you call your problem?
• What do you think caused it? Why?
• What do you think your sickness does to you?
• How severe is it? Short or long course?
• What do you fear the most?
• What are the hardest problems this causes you?
• What kind of treatment do you feel you need?
• What results do you hope for?
48. Vermont Child Health Improvement Program(VCHIP)
Creating an electronic Shared Plan of Care (e-SPoC)
Patient-Centered
Medical Homes
VCHIP at University
of Vermont
Vermont
Department
of Health
Our Families &
Family Health Partners
51. PARENTS’ VOICES
NO CARE
COORDINATION
• “There was no continuity. We
would call the primary care
office with a concern and they
would say “Oh, you need to
talk to your specialist about
that.” We would call the
specialist and they would say
“Oh, you need to talk to your
primary care doctor about
that.” It was just back and forth
all the time and the concerns
never got addressed.”
WITH CARE
COORDINATION
• “Now there is a sense that I’m
being listened to – that his
medical needs are being
addressed. We have a plan with
where we are headed, especially
with the school, we know where
we are going.”
Maier, Parent interview, March 6, 2014
52
54. MORE ON CARE PLANNING AND
CARE COORDINATION
www.lpfch.org/publications
• A compendium of publications on care coordination, including Achieving a
Shared Plan of Care with Children and Youth with Special Health Care Needs
www.lpfch.org/about-us/webinars-conferences-convenings
• Coordinating Care for Children with Social Complexity – webinar materials
• Take Action on Care Coordination – webinar materials
www.lpfch.org/symposium/webcast
• Webcast and presentation slides from the 2015 Symposium:
Designing Systems That Work for Children with Complex Health Care Needs
55. Jill S. Rinehart, MD, FAAP
Partner, Hagan, Rinehart & Connolly
Pediatricians, PLLC, and
Clinical Associate Professor of
Pediatrics at the University of Vermont
College of Medicine
jillrinehartmd@gmail.com
www.hrcpediatricians.com
Annique K. Hogan, MD
Medical Director, CHOP Compass Care and
Integrated Care Service,
Children’s Hospital of Philadelphia
HOGAN@email.chop.edu
www.chop.edu
Jeanne W. McAllister, BSN, MS, MHA
Associate Research Professor of Pediatrics
Indiana University School of Medicine, Children's
Health Services Research Division
Jwmcalli@iupui.edu
CONTACT US