Improving team-based care for children: shared well child care involving family practice nurses

Abstract

Introduction: Well child care (WCC) is the provision of routine preventative care and vaccinations to infants and children. In Canada, physicians provide the majority of this type of care, whereas in other developed countries, nurses provide most WCC. New models of shared care between nurses and family physicians should be explored. Objective: This pilot project aimed to evaluate the feasibility and acceptability of shared nurse–physician WCC for a cohort of healthy children. Methods: A total of 20 participants had nurse–physician alternating WCC visits, which were compared with physician-provided WCC visits. The feasibility was evaluated through chart audits and the acceptability was evaluated through interviews with the physicians, nurses, and the patients’ parents. Results: The results showed that physicians and nurses discuss a similar percentage of Rourke Baby Record topics, and that families and clinic staff were accepting of this new model of care. Conclusion: This intervention could liberate time for Canadian family physicians, thereby improving access to care.

Healthcare professionals’ perceptions about interprofessional teamwork: a national survey within Swedish child healthcare services

“…Professionals working in Family Centers were more likely to report all types of investigated teamwork as well as a perception of continuity within the team. Our findings correspond with previous studies showing the importance of co-location for enabling teamwork [ 21 , 23 , 45 , 46 ]. Family Centers are co-locations that engage different healthcare professionals [ 37 ], intended to enable healthcare with the child in the center in order to meet the needs of the child and his or her family.…”

“…In the Swedish NCHP, team-based visits are defined as physical meetings between different healthcare professionals, the child, and the family [1,9]. In previous studies regarding teamwork in CHS, teamwork has been defined as "shared care," implying that nurses and physicians provide separate activities [3,[20][21][22][23]. Nelson et al [28] describe a clinical microsystem as living units, having the person with his or her health needs in the center with professionals coming together to meet the needs of the individual, in this case children and their families.…”

“…The concepts 'interprofessional teamwork' and 'interprofessional collaboration' are often used interchangeably, which has been problematized in previous research [13][14][15]19]. The different conceptual interpretations for teamwork [13][14][15]19] also concern studies regarding CHS [20][21][22][23]. Reeves et al [12,19] distinguish between interprofessional teamwork and other forms of interprofessional practice [12,19].…”

Influence of organisational attributes on registered nurse contributions to well-child care: a scoping review protocol

“…Universal access to preventative healthcare is essential to children’s health 1 and RNs are well equipped to address the unique needs of children within the context of well-child care in the primary care setting. 2 Well-child care is defined as the delivery of the combined elements of care: health supervision, anticipatory guidance, growth/development monitoring and immunisation, with the goal of promoting optimal trajectory for growth and development. 1 3 Well-child care includes identification of influences that can positively and negatively affect health outcomes.…”

“…For the purpose of this review, well-child care is defined as the delivery of the following combined elements of care for children 5 years of age and younger: health supervision, anticipatory guidance, growth/development monitoring and immunisation, with the goal of promoting optimal trajectory for growth and development. 2 The care includes identification of influences that can positively and negatively affect health outcomes. In Canada, the Rourke Baby Record 13 is considered the best practice standard for well-child care for children 5 years of age and younger.…”