The Health Care Team System
“Every wise physician knows that the best he can do for a patient [family] is to assist nature in healing” (18).
It is important to keep in mind that the best health care is given when both the parent and the health care team work in conjuction with one another.
As in any relationship, communcation and mutual respect are essential. Fallowfield (19) reminds us that parents may have difficulty hearing the information regarding their child and that information from the caregiver may often need to be repeated. Furthermore, when giving critical information regarding the patient's illness or disability, it is practical for the practioner to have a “plan” to reinforce that the family has heard/under- stood the information that is being presented (19).Davis (17) offers suggestions to organizing your “plan” when giving critical information to a family member or caregiver:
1. Begin with what the parent/family knows; ask specific questions, such as:
“When we spoke last, you asked...”
“What is your understanding of your child's disability?”
“What did the emergency department physician tell you about the accident?”
2. Present the information. Facts and data are important in this segment of the conversation, but in small, digestible parts that parents can integrate into their knowledge base.
3. Check the result. Observe the family and their reaction to the information that is currently being presented. Invite the family at this time to ask questions or receive clarification.
4. Ensure retention.
It is also wise to offer written information about the specific topic, and refer to appropriate members of health care team (ie, case manager, social worker, psychologist) who can continue to process this information with the family. Many families may request an audiotape of the interview with the physician to share with other family members.
The authors suggest that this process be established before the interview begins to ensure the privacy of the people involved.When an audiotape is not appropriate, Cunningham and Newton (20) reported that using a written consultation questionnaire was also highly effective in confirming that families understood the medical information being presented. This tool became valuable to the parents as an effective means to communicate with the medical team and offered a voice to parents who were not confident to prepare individual questions themselves.
Stille and Antonelli (21) summarize in their article, “Coordination of care for children with special health care needs,” that coordination is highly dependent upon communication.” They go on to explain that “a team approach involving nonphysican staff and families as primary partcipants to be the best option in health care.” Furthermore, it is the responsibilty of all members of the health care team to assist patients and families during all aspects of the child's illness or disability. The hope for all members of the health care team is that we view children and their families within a holistic approach, acknowledging that as a team we are separate and at the same time equal.