Care Partnership Support

Care partnership support addresses family access and communication—the hallmark of an effective family-centered medical home. In this section, you will find resources and tools to ensure family-centered care and enhance communication between a practice and its patients and families. This page provides additional resources as to what is provided in the Care Partnership Support section of the Building Your Medical Home toolkit.

What Is Patient-and Family-Centered Care?

According to the core principles PDF developed by the Institute for Patient- and Family-Centered Care, patient- and family-centered care 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. It redefines the relationships in health care.

The National Partnership for Women & Families developed nine principles of family-centered carePDF to guide the development and implementation of the medical home. These principles emphasize care that puts the patient first, emphasizes open communication, and supports the patient and his or her caregivers.

The Maternal and Child Health Bureau (MCHB) PDF defines family-centered care as a respectful family/professional partnership that honors the strengths, cultures, traditions, and expertise that everyone brings to the relationship. Family-centered care is the standard of practice which results in high quality services.

NewPositioning the Family and Patient at the Center: A Guide to Family and Patient Partnership in the Medical Home PDF
Developed on behalf of the National Center for Medical Home Implementation by Rebecca A. Malouin, PhD, MPH, this monograph illustrates how pediatric primary medical care is evolving into family-centered care featuring partnerships between families and providers. To understand the characteristics of a family-centered medical home, a literature review was performed and case studies were conducted on the medical home strategies, tools, and procedures of 17 pediatric primary care practices located in Minnesota, Michigan, North Dakota, New Hampshire, North Carolina, Vermont, New York, Illinois, Indiana, Alaska, Wisconsin, Oregon, Massachusetts and New Mexico. These practices were nominated by their peers as exemplary family-centered medical homes.

  • A companion piece PDF to the monograph includes a list of resources to help practices enhance their family-centeredness. These resources will help pediatric providers work with families to improve care access, management, communication, cultural sensitivity, quality improvement and enhance opportunities for meaningful patient and family feedback.

Medical Home Interview Videos on Family-Centered Care
Developed by the National Center for Medical Home Implementation

Health Affairs and the 'New Era of Patient Engagement' Briefing
In February 2013, six panels gathered to discuss the issues relating to patient involvement in their care, including topics such as quality outcomes, models for engagement, stakeholder roles, end-of-life care and more. Keynote speaker Howard Koh, the Department of Health and Human Services Assistant Secretary for Health, opened the day's conversation.

For additional information on family-centered medical home, visit the Family-Centered Medical Home Overview page of the NCMHI Web site.

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Marketing Your Medical Home

Brochures and Flyers
Creating a brochure for your practice is a great way to communicate to patients about office hours, contact information after normal business hours, and other key health information. 

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Coloring Sheets and Bookmarks

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Posters

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Practice Web sites
For additional information on how practice Web sites can help to support the medical home, visit the Health Information Technology (HIT) page of the NCMHI Web site.

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Welcome Letters

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Culturally Competent Care

In an effective medical home, the child’s or youth’s and family’s cultural background, including beliefs, rituals, and customs, are recognized, valued, respected, and incorporated into the care plan. Further, all efforts are made to ensure that the child or youth and family understand the results of the medical encounter and the care plan, including the provision of (para)professional translators or interpreters, as needed.

Resources for Patients/Families

Resources for Providers

Promising Practices in Cultural Competency

  • Health Care Innovations Exchange
    The Agency for Healthcare Research and Quality (AHRQ)
    This Web site features several promising practices to reduce health disparities among children, including a program that provides culturally competent asthma care to Latino families, a state policy that increases access to Medicaid coverage for uninsured children, and a medical center's use of text messaging to increase vaccination rates among low-income minority children. The featured QualityTools present resources and information to help health care providers and other organizations deliver culturally appropriate services and improve care for at-risk children.
  • Improving Patient-Provider Communication Video
    Joint Commission and the US Department of Health & Human Services (HHS) Office for Civil Rights
    This video highlights what is required by Joint Commission standards as well as Federal civil rights laws with respect to patients who are deaf/hard of hearing or limited English proficient. 
  • Quality Care for Diverse Populations—Clinical Video Vignettes
    American Academy of Family Physicians (AAFP)
    This educational program includes five video vignettes depicting simulated physician-patient visits in an office setting as a means to explore ethnic and sociocultural issues found in today's diverse health care environment.
  • A Comprehensive Framework and Preferred Practices for Measuring and Reporting Cultural Competency
    National Quality Forum (NQF)
    This report outlines a roadmap for reducing disparities and introduces a framework for reporting on culturally competent and patient-centered services. The report endorses 45 practices to implement this framework and begin reducing disparities in communities.
  • Healthy Tomorrows Grantee Experiences—Culturally Responsive Health Education/Training
    The AAP hosted a webinar that highlighted a Healthy Tomorrows grantee's experiences of creating culturally responsive health education materials and training providers how to manage diverse health literacy levels. Audio recording, PowerPoint presentation, and transcripts are now available on the Community Pediatrics Web site.

Language Access Survey: Information from the Field
A Collaborative Project Between the National Center for Cultural Competence and the National Center for Medical Home Implementation--Summer 2012
This goal of this research study was to collect information from pediatric providers on how they address language access services in their practice. An online 22-item questionnaire was distributed between April-June 2012 to more than 3,200 AAP members and 35,000 subscribers to AAP SmartBrief. The results of this survey were shared in poster presentations at two national conferences: the American Academy of Pediatrics Peds-21 Symposium at the National Conference and Exposition in October 2012, and the Association of Maternal and Child Health Programs Annual Conference in February 2013. In March 2013, two pediatricians who participated in the survey served as faculty on the 'How to Enhance Care Delivery for a Diverse Population' webinar as part of the 2013 Medical Home in Pediatrics: The HOW TO Webinar Series.

Survey Respondents:

  • 154 responses were collected
  • 42% described themselves as located in some non-institutional practice setting
  • 37% practice in a university, hospital or community health center setting
  • 21% practice in an array of other settings

Results:

  • 58% have  bi-lingual physicians in the practice setting
  • 56% noted that there was other bi-lingual staff 
  • 43% reported using bi-lingual family members as interpreters
  • 42% reported using some type of professional interpreters (e.g., telephone interpreters, contract interpreters and video interpretation); of these, 63% were in institutions such as hospitals, public clinics or medical schools
  • 42% using translated documents reported using documents known to have been created by professional translators
  • 25% reported that their practice team or staff had formal training in working with interpreters to create an effective patient encounter
  • 25% did not know if their practice had a language access plan; 39% said that no such plan existed
  • 17% of respondents had in place some kind of formal mechanism to get feedback about language access services 

Conclusion

  • Providing effective, high quality language access services to patients and their families within the pediatric setting is paramount
  • Clinical encounters require planned services and supports to mitigate communication barriers via a cadre of language access services
  • This indicates a need for pediatric practitioners to learn skills necessary to work well with professional interpreters and to evaluate the quality and effectiveness of such services

More information and data from the AAP on Changes in Language Services Use by US Pediatricianscan be found in the July 2013 issue of Pediatrics.                   

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Health Literacy

American Academy of Pediatrics (AAP) Resources

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Agency for Healthcare Research and Quality (AHRQ)

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Health Resources and Services Administration (HRSA) Resources

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Toolkit for Making Written Material Clear and Effective
Centers for Medicare and Medicaid Services (CMS)
This toolkit contains 11 sections that provide a detailed, comprehensive set of tools to help make written material in printed formats easier for people to read, understand, and use, including culturally appropriate translation, graphic design guidelines, feedback collection from readers, and more.

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Washington Learning Systems—Vietnamese Parent-Child Early Literacy Activities
Washington Learning Systems
These materials, designed for children birth to 3, encourage early language and literacy development and address the three key skills of language development, sounds and rhythms, and general book and print awareness.

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Family Advisory Groups

Medical Home Interview Videos New
Developed by the National Center for Medical Home Implementation

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Institute for Patient- and Family-Centered Care Resources

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National Initiative for Children's Healthcare Quality (NICHQ)

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Parents as Primary Care Policy Advisors PDF
The Parent Advisory Group at Nashaway Pediatrics, Sterling, MA. Promising Practices: Family-Professional Collaborations That Promote Improvement in Services for Children With Special Health Care Needs - Massachusetts Consortium; June 3, 2004.

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Resources on Involving People with Disabilities as Members of Advisory Groups
Montana Disability and Health Program
These guidelines offer suggestions and resources on how to involve people with disabilities as active members and advisors of local and community groups.

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Title V Toolbox for Family Participation
Family Voices
This toolbox has materials created by states to develop family advisory committees or councils. Descriptions, guidelines, by-laws, and information forms are available.

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Engaging Patients in Improving Ambulatory Care Toolkit
Aligning Forces for Quality
This toolkit showcases patient engagement efforts from three alliances participating in Aligning Forces for Quality, the Robert Wood Johnson Foundation’s effort to lift the quality of care in targeted communities.

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General Publications on Parent Advisory Groups

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Self-Management

Agency for Healthcare Research and Quality (AHRQ) Resources

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Let’s Move Child Care Checklist PDF
The checklist underscores five principles, including one to two hours of daily exercise and zero screen time for children younger than 2. The checklist is a guide for parents and child-care centers to help improve children's health. She also noted that 1,600 child-care centers in the US have committed to promoting healthy eating and exercise habits.

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Partnering in Self-Management Support: A Toolkit for Clinicians doc
Institute for Healthcare Improvement
The concepts in this toolkit are intended to give busy clinical practices an introduction to a set of activities and changes that support patients and families in the day-to-day management of chronic conditions. The toolkit includes tested resources and tools and high-leverage changes and offers a number of ways to begin trying them with a small number of patients.

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Text4baby
A free mobile information service designed to promote maternal and child health. The AAP has partnered with the National Healthy Mothers, Healthy Babies Coalition (HMHB) to provide this educational program that arms pregnant women and new moms with information they need to take care of their health and give their babies the best possible start in life. Women who sign up for the service by texting BABY (or BEBE for Spanish) to 511411 will receive free SMS text messages each week, timed to their due date or baby’s date of birth.

 

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Measuring Care Partnership in Your Practice

CAHPS Clinician & Group Survey
CAHPS Improvement Guide—Practical Strategies for Improving the Patient Care Experience
The Agency for Healthcare Research and Quality (AHRQ)
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Family-Centered Care Self-Assessment Tool—Provider Tool PDF
Family Voices

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Medical Home Family Index PDF
Center for Medical Home Improvement (CMHI)

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Patient-and Family-Centered Ambulatory Care: A Checklist PDF
Institute for Patient- and Family-Centered Care

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Promising Practices

Medical Home Interview Videos New
Developed by the National Center for Medical Home Implementation

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ChildrensPgh App
The Children's Hospital of Pittsburgh has developed a mobile application called ChildrensPgh. It allows parents to access information on making online medical appointments, contacting providers and going to the hospital's emergency department. The iPhone app also provides some basics on first aid and medication dosing.

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Family Experiences and Pediatric Health Services Use Associated With Family-Centered Rounds
This article published in Pediatrics in August 2012 highlights the results of a study that compared families with a child admitted to general pediatric inpatient services both with and without family-centered rounds. The results showed that families that experienced family-centered rounds were more likely to report consistent medical information, the option of discussing care plans, that doctors listened carefully, and that doctors showed respect. These results indicated that family-centered rounds are associated with “higher parent satisfaction, consistent medical information, and care plan discussion, with no additional burden to health service use.”

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Indiana University Podcasts
The Courier-Journal reports that the Indiana University School of Medicine and the Riley Hospital for Children in Indianapolis began a monthly, 30-minute podcast called Kids Healthcast that offers information on pediatric health issues, such as childhood obesity, to families. Project supervisor Dr Deanna R Reinoso said that the podcasts are designed to provide general health information and that parents should still consult pediatricians for specific health concerns.

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Medical Home Tools in the News—East TN Kids iPhone App
East Tennessee Children's Hospital has a new iPhone/iPod application that allows parents, grandparents, and caregivers to input children's medical history into the convenient, portable, and password protected application. Use of this application is an example of parents taking an active roll in partnering with their physician to manage and track their child’s care. The East TN Kids app also has a KidsHealth section that is stocked with hundreds of articles on health, first aid, safety, medical problems, infections, emotions and behavior, growth and development, nutrition and fitness, pregnancy and newborn care.

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My Child’s Map to Services
Family Voices of Washington
This guide for families in accessing community services is a quick reference guide for families just receiving a new diagnosis of Autism for their child by providing information on therapeutic services and contact information for state services, including family-to-family support. The language utilized throughout the tool is clear and appropriate for all families, regardless of income or insurance coverage. It is available in Spanish and in versions for Korean and Cambodian communities.

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The Patient-Centered Medical Home: Strategies to Put Patients at the Center of Primary Care
Agency for Healthcare Research and Quality (AHRQ)
This brief highlights opportunities to improve patient engagement in primary care and focuses on involvement at three levels: the engagement of patients and families in their own care, in quality improvement activities in the primary care practice, and in the development and implementation of policy and research related to the patient-centered medical home (PCMH).

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Patient-Physician Communication: It’s About Time
Journal of the American Medical Association
In this article, the authors offer strategies for the medical profession to make a renewed commitment to "excellence in the communication skills of physicians" in order to decrease medical errors, and improve quality, safety, and the patient experience of care.

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Primary Care/Medical Home
As featured on the Institute for Patient- and Family-Centered Care Web site, learn how several practices in Connecticut, Massachusetts, and Minnesota implement family-centered care.

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More Communication Tips

Delivering Difficult News
Frances P Glascoe, PhD
Information for physicians on delivering diagnosis/results to patients.

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Interpreting Screening Tests to Families and Encouraging Follow Through
Frances P Glascoe, PhD
Offers tips for explaining screening results and recommendations to parents

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Patient-Centered Interactions Implementation Guide
The Safety Net Medical Home Initiative
Sponsored by The Commonwealth Fund, in collaboration with eight co-funders, The Safety Net Medical Home Initiative is a five-year demonstration project designed to help 65 community health centers in five states transform into patient-centered medical homes. Through this demonstration project, implementation guides are available for the following key building blocks of a medical home: empanelment; team-based care; patient-centered interactions; engaged leadership; and enhanced access.

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Patient-Clinician Communication: Principles and Expectations
Institute of Medicine
This publication outlines the key principles for achieving patient-centered care by improving communication between patients and healthcare providers. The report also emphasizes the importance of cultural and environmental factors to the success in achieving expectations for the care experience.

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Provider Resources for Vaccine Conversations with Parents
American Academy of Pediatrics , Centers for Disease Control and Prevention (CDC), American Academy of Family Physicians

 

 

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