Presentation on theme: " 1. The changing epidemiology of pediatric practice. 2. The emergence of new technology. 3. The impact of racial and ethnic disparities. 4. The."— Presentation transcript:
1. The changing epidemiology of pediatric practice. 2. The emergence of new technology. 3. The impact of racial and ethnic disparities. 4. The greater prevalence of women in pediatric practice 5. Changes in health care financing. 6. International models.
Better disease prevention Improved care of kids with chronic disease Increased survival of VLBW babies Results: 75% of health care dollars goes to kids with chronic and disabling conditions CSHN are 12.8% of kids <18 Almost 60% of parents of CSHCN do not feel partnership with providers of care
The child is a 5 year old born full term to a woman with bipolar disorder and p.t.s.d. Normal L&D. 4 mos of age: surgery for a vascular ring ended badly. Chylothorax, chest tube, seizures, acidosis, ventilator. Child currently has a developmental level of a two year old, is in special education, has required a g-tube, orthopedic procedures for contractures and dislocated hips. Currently in the Model Waiver Program.
Parent/Guardian Pediatrician School Staff Funding Agency Attorney/ GAL
Different Definitions Different Styles Different Perceptions of Self/Others Everybody thinks they’re the most important
Goals Objectives Methods Metrics of Success …..Progress …..End Point(s)
The use of lay health workers, compared to usual healthcare services: - probably leads to an increase in the number of women who start to breastfeed their child; who breastfeed their child at all; and who feed their child with breastmilk only; - probably leads to an increase in the number of children who have their immunization schedule up to date; - may lead to slightly fewer children who suffer from fever, diarrhoea and pneumonia; - may lead to fewer deaths among children under five; - may increase the number of parents who seek help for their sick child.
Role Separation Overestimation and Disappointment Realistic Appraisal Accommodation Integration
Structure of Stages: 1. Information Exchange 2. Role Clarification 3. Goal Clarification 4. Negotiation 5. Decision Making
Role Sep: Traditional Boundaries Disappointment: Inapp. Expectations Realism: Open to accepting info from each team member Accommodation: Info shared compliments that from other team members Integration: Recognition of expertise and special knowledge
Role separation: Maintain traditional roles Disappointment: Role Ambiguity Realism: Recog of potential contribution; less boundaries Accommodation: Permeability of boundaries Integration: recog of expertise and spec. capabilities
Goal setting remains separate---- Systemic view of Goals Negotiation Anxiety, competitiveness---- Non-threatening, open comm
Role Separation: Power of position Disappointment: Overestimate of ability to make decisions Realism: More open to mutually-agreed upon decisions Accommodation: Increasing agreement on decisions of intervention Integration: Sharing of moral responsibility
Increasing numbers of children with special needs demand a collaborative approach Community Partners need to understand the new model of the, “office without walls.” The new model requires an appreciation of the models for collaboration