Podiatrist Liz O’Malley discusses the role – and importance – of client centred care for younger clients; shining an evidence-based light on the difference podiatrists can make.
The benefits of holistic, client-centred care for all of our podiatry clients are well established, and our youngest clients should not be exempt from these benefits. The overall success of family-centred care has been well discussed, with most paediatric hospitals using a family-centred approach to their policies [1].
To explore the idea of child-centred care, Queensland Health describes child-centred care as:
“A philosophical approach and a set of principles to guide the planning, delivery, evaluation and continuous improvement of healthcare that is grounded in active partnership between healthcare providers, children and families, at a level that reflects the child’s competence and of the family’s choosing”[2].
Key concepts of family-centred care are:
Respecting and understanding a family’s values, wishes, priorities and cultural requirements are all imperative principles of a family-centred approach. Involvement of the families and their care givers – and giving our young clients a voice – will enable better communication between clients and health care professionals; and better treatment outcomes. In providing family-centred care, the patient, their family and healthcare providers should also have the opportunity to contribute to the goals of their treatment plan[3].
The Charter of the Rights of Children and Young People in Healthcare Services in Australia gives further insight into the recognised vulnerabilities of children, their differential needs compared to adults, and the dependence of children on adults to be able to access appropriate healthcare[4].
As podiatrists we are taught to see the client as a whole person, not just a pair of feet. One way to ensure we are providing the best care for our younger clients is to enable multi-disciplinary care.
The use of multi-disciplinary clinics has been globally established across many areas of health care. One such example are the UK standards of care for Juvenile Idiopathic Arthritis (JIA) which state that all young people diagnosed with JIA should have access to a paediatric rheumatologist, clinical nurse, physiotherapist, occupational therapist, psychologist and ophthalmologist.[5]
The multi-disciplinary team in health care allows for varied and complimentary skills and qualifications to all contribute to the successful attainment of goals. This type of multi-disciplinary approach has widely been proven beneficial in primary health care, shown to reduce hospital stays, decrease complications, and reduce levels of anxiety and depression[6]. This approach is evident in many paediatric tertiary health care services where care for the paediatric population is provided through multi-disciplinary teams[7].
Within a paediatric musculoskeletal service, this may include podiatry alongside physiotherapy, occupational therapy, and exercise physiology; with a referral pathway in place to paediatricians, general practitioners, and orthopaedic surgeons. Whilst each health professional is able to provide a unique set of assessment and management skills; together, the care for the client’s holistic needs will be improved. In my experience, recent satisfaction surveys of families attending a multi-disciplinary gait clinic reported improved confidence when managed within a team.
Each practice will be different in how they can facilitate family-centred care and multi-disciplinary management into their care planning. In community health settings or larger practices, where our complementing discipline is in the next room, the implementation will be less complex. Smaller clinics can start by increasing the communication with their referral base as a first step. Implementing telehealth meetings for interdisciplinary planning and communication can also be a great way to increase communication with other clinicians. Elsewhere improvements in our health language/literacy may help facilitate family-centred care[3]. Increasing your multi-disciplinary communication streams can help your clients to obtain their goals and increase your advocation.
The Institute for Patient and Family Centered Care, based in America, has some resources to further your understanding and the Hush Foundation has other limited resources[10].
References
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