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 professionals, patients, and families. It redefines the relationships in health care by placing an emphasis on collaborating with people of all ages, at all levels of care, and in all health care settings. This collaboration assures that health care is responsive to priorities, preferences, and values of patients and their families. In patient- and family-centered care, patients and families define their “family” and determine how they will participate in care and decision-making. This perspective is based on the recognition that patients and families are essential allies for health care quality and safety—not only in direct care encounters but also in efforts to improve health care for all, including in research.
Core Concepts of Patient- and Family-Centered Care
Dignity and Respect. Health care practitioners listen to and honor patient and family perspectives and choices. Patient and family knowledge, values, beliefs, and cultural backgrounds are incorporated into the planning and delivery of care.
Information Sharing. Health care practitioners communicate and share complete and unbiased information with patients and families in ways that are affirming and useful. Patients and families receive timely, complete, and accurate information in order to effectively participate in care and decision-making.
Participation. Patients and families are encouraged and supported in participating in care and decision-making at the level they choose.
Collaboration. Patients, families, health care practitioners, and health care leaders collaborate in policy and program development, implementation, and evaluation; in research; facility design; and in professional education, as well as in the delivery of care.
Learn more about patient- and family-centered care at www.ipfcc.org.
Health practitioners promote service satisfaction and self-assurance by maintaining a familial bond during pediatric treatment with a value system called family centered care. Providers and organizations adopting this philosophy promote emotional, physical, and psychological health among children during treatment. Family centered care has evolved from literary works penned by practicing nurses over the last seven decades. Nurses practice the method as a means to build a rapport that facilitates fulfillment of the needs of all stakeholders.
This once prohibited practice now receives increased acceptance, bolstered by highly compelling empirical evidence. Using this approach, nursing professionals create an environment that recognizes parents as critical information sources and part of the caregiving team. While many pediatric practitioners have accepted family centered care as an effective value system, many more have yet to incorporate it into their repertoire.
Pediatric practitioners who adopt family centered care techniques recognize how important it is to include family members in the evaluation, delivery, and planning of treatment and incorporate that ideology into assessments, facility design, policies, programs, and routine interactions. These care providers understand the important role that family members play in children’s wellness.
Pediatric care providers who follow family centered service principles treat each child as an individual and support family values and strengths to promote positive patient outcomes. These professionals also engage families in a way that supports emotional development and reassures family members that they are an important component in their child’s treatment.
The fact and views presented by the patient and their family members comprise important influences in clinical decision-making. Confident and informed family members reinforce children’s strength and courage. Bearing this in mind, the following five innovative practices can help pediatric care providers improve patient outcomes.
1. Open Communication with Family Members
Open communication in pediatric and neonatal wards lead to improved patient and familial satisfaction. These outcomes improve patient safety and stakeholder candidness. When clinical errors occur, a relationship built with open communication plays a critical role in how stakeholders perceive the event.
Family centered pediatric practitioners share information and encourage patient participation during treatment while maintaining privacy rights, especially among disabled children, and respect children’s ability to make appropriate decisions. When conducting research, family centered pediatricians defer to patient and family member views on project participation and information sharing. Communication also improves performance among medical personnel.
2. Recognizing Familial Importance
Patient and family centered care started to emerge in the 1950’s. The practice holds special relevance for families raising children with special needs, as well as low-income, minority, and uninsured families.
The doctrine reduces incurred costs and improves the experience realized by patients and family members. By keeping family members present during treatment, pediatricians decrease stakeholder apprehension and create a supportive setting for family members, while encouraging patient interaction and promoting a healing environment.
3. Family and Organizational Collaboration
At family centered practices, family members serve as the patient’s advisors, committee, and task force for promoting the best possible treatment outcome.  A supportive environment encourages family members to participate in value added groups, such as peer networks, quality improvement initiatives, and safety committees. Family centered value adoption starts at the executive level with appropriate guidance and resource allocation and then proliferates throughout the organization.
As it pertains to family centered care, collaboration encompasses complementary patient engagement, or if necessary, a guiding voice that encourages patient and family participation in the treatment process. New mothers commonly seek this kind of professional interaction.
Collaboration streamlines treatment and produces optimal health experiences. By combining their assets, beliefs, and capabilities, family members and care providers make enhanced decisions that best serve the needs of the patient.
4. Enabling Family Members to Support Treatment
Professional perceptions and attitudes can delineate the effectiveness of family centered care. To deploy the philosophy successfully, pediatric nurses must relinquish some, but not all, control to family members. To facilitate this, nurses must guide family members in caring, protecting, and making decisions for pediatric patients.
Most nurses are aware of the family centered practice concept. Entry-level nursing staff members may have difficulty relinquishing partial control to family members. However, experienced nurses typically feel more at ease with the idea, which empowers parents and guardians by enhancing their ability to play an active role in their child’s treatment.
5. Encouraging Cultural Literacy
The best methods to deliver care can change with cultural identity. Respect and honor for cultural differences represents a primary tenant in promoting family centered pediatric care.  Staff members who belong to various cultures can help their peers understand intercultural needs.
Each family unit also shares distinct cultural beliefs. Children learn their characteristics, heritage, and spirituality from their family members. Pediatric practitioners must identify and learn to relate to other cultures to understand the factors that contribute to patient health.
High-quality family centered care improves wellness among pediatric patients. When family members provide strong support during treatment, children feel calmer and more relaxed and require less medication to recover from painful injuries.
Family centered treatment promotes winning outcomes for patients, family members and care providers. For that reason, pediatricians should promote a family centered agenda in all aspects of their practices.
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Pediatric NP Job Roles and Responsibilities
 American Academy of Pediatrics
Patient- and family-centered care (PFCC) is changing the way hospitals provide patient care, increasing staff satisfaction, decreasing costs, and improving patient outcomes [1, 2]. Although hospitals make unique, organization-specific PFCC principles, all of them tend to endorse similar core values by recognizing the importance of family members’ roles in individual patients’ health care experience, establishing relationships with and supporting patients and families, and helping patients discover how their own strengths and weaknesses influence their health and health care. When patients’ needs are prioritized, they engage in treatment and the treatments are more effective [1-4]. Hospitals where PFCC is part of the organizational culture find not only that patient, family, and staff satisfaction ratings significantly increase, but also that patients’ health outcomes improve [2, 5]. Implementation of PFCC is also correlated with a decrease in patients’ emergency department visits, faster recovery, and decreased utilization of health care resources [2, 6-7].
PFCC has become widespread throughout health care [6, 8-12]. The PFCC concepts of patient-physician collaboration and treating the patient as a whole person are not new. Fifteen years ago, the Institute of Medicine (IOM) semi-annual report, Crossing the Quality Chasm , included PFCC as an initiative to improve quality in the list of ten rules for redesigning health care . The IOM report emphasized the need to involve patients in their own health care decisions, to better inform patients of treatment options, and to improve access to information . PFCC provides a holistic approach to patient care, including psychological, spiritual, cultural, and emotional considerations that contextualize experiences of illness or injury and go beyond a focus on disease processes only .
The term “family-centered” does not remove control from competent patients to make decisions concerning their own health care . Instead, this concept emphasizes that a patient’s health care decisions should be contextualized in terms of a patient’s broader life experiences. This term also recognizes the role a patient’s family members play in extended and at-home care planning and care giving.
As medical care continues to become more collaborative, with a focus on holistic care for patients and their sources of support, principles of PFCC are now commonly taught to medical residents [14, 15]. For example, to be recognized by the Magnet Recognition Program, developed by the American Nurses Credentialing Center, hospitals must implement family-centered care . No longer just for pediatrics, patient- and family-centered care applies to patients of all ages and can be practiced in any health care setting and at any point in care delivery; the Joint Commission suggestions include providing discharge instructions that meet the patient’s needs, informing patients of their rights, and identifying patients’ dietary restrictions that affect treatment . Giving patients control, customizing care according to patients’ needs and values, and providing information to patients and their loved ones are other IOM recommendations that promote PFCC .
Recognizing the importance of patients’ loved ones in patients’ health care experiences, clinicians try to work with patients and families to ensure their health and well-being in a mutually beneficial relationship [8, 11, 12]. Principles of PFCC include listening to families, facilitating choice, sharing information, and building confidence to participate in health care decision making [2, 11]. By implementing PFCC, clinicians benefit by gathering more information, improving follow-through, making efficient use of professional time, and decreased health care utilization [6, 9, 11].
Based on the latest research and guidelines [1, 4, 10, 14], these strategies for successful patient- and family-centered care are suggested:
Prominent organizations including the Institute of Medicine (IOM), the Institute for Patient- and Family-Centered Care (IPFCC), the Institute for Healthcare Improvement (IHI), the American Academy of Pediatrics (AAP), and the American College of Emergency Physicians have endorsed PFCC practices, helped to define PFCC, and illustrated the importance of incorporating patients and their loved ones into health care discussions and decisions [8-12]. PFCC improves quality and safety of care, chronic disease management, and patient satisfaction; reduces hospitalizations and medical errors; and lowers costs [1, 2, 6, 11, 17, 21].
AMA J Ethics. 2016;18(1):40-44.10.1001/journalofethics.2016.18.1.medu3-1601.
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The viewpoints expressed in this article are those of the author(s) and do not necessarily reflect the views and policies of the AMA.