Advances: Change - Double Issue (1995)
Table of Contents:
- Change: It's Happening Everywhere (see article below)
- Family-Centered Change: A strategic goal at Children's Hospital of Philadelphia
- Minnesota Merger: Values drive culture change
- Prenatal Care Coordination in Wisconsin: A family-centered statewide system of care
- MassCARE: Family-centered change - an ongoing process
- Learning to Dance Together: The steps to family/provider collaboration
- Change: A catalyst for conflict and growth
- The Primary Care Practice: Families as partners in planning
- Families Are Partners in Creating a Community School
Change:
It's Happening Everywhere
It's been said that the only thing in life we can count on is change. The question is not whether change will occur, but rather how we can creatively shape and direct change to make our world more humane and more whole. Today, profound changes are occurring throughout our country's health, education, and social service systems-changes that will shape the well-being of the American people well into the next generation.
Across the country, professionals and consumers agree that many of the organizations and systems we have created over the past few generations are no longer working for millions of American children and their families and must be changed. In hospitals, schools, and all kinds of community programs developed over the years to serve society's most vulnerable members, it's increasingly clear that we need new and better ways to ensure the healthy futures of America's children and their families.
Change toward managed care is occurring rapidly throughout the health care system and, in large part, in the absence of federal standards. In the national debate about Medicare and budget reform, more attention is being focused on financing than on the organization of service delivery, including such vital issues as quality and access to services.
These economic and political pressures are driving fundamental structural changes such as downsizing, restructuring, and reduced services in hospitals and other public and private institutions that serve women and children. At the same time, new technologies are changing what's possible in health care, while highlighting the very real limitations of narrowly technological treatments that focus strictly on disease and deficits.
As these changes occur, we are also experiencing a new awareness of the tremendous resources and strengths of children and their families in all kinds of circumstances, as well as greater awareness of their very real needs. This awareness is driving another kind of change-in the basic philosophy and approach to programs and policies affecting children and families. Throughout the service system, professionals and families are coming to the same conclusion: that full collaboration between professionals and families is a more effective and less costly way to improve the long term health and well-being of children and their families.
As financial and structural forces accelerate change throughout the health care system, it is more vital than ever that families and professionals work together to ensure that our knowledge about the effectiveness of family-centered care is not lost, but becomes a strategic tool for positive change.
Family-centered care represents a fundamental shift in thinking and practice:
- from a disease and deficit focus to one that identifies and builds on individual and family strengths;
- from reliance on professional and institutional expertise toward partnerships and collaboration;
- from practices that foster dependency to those that empower children and families;
- from an over-reliance on costly technologies to an awareness that we can no longer afford to concentrate on treatment alone, but must pay greater attention to preventing disease and promoting health;
- from an exclusively professional focus to an awareness of the value that paraprofessionals can bring to the system; and
- from building isolated "centers of excellence" to rediscovering the importance of community involvement and community partnerships.
As the articles in this issue demonstrate, family-centered philosophy is reshaping organizations and services in exciting new ways throughout the service system. Change is occurring across the board in hospitals, physician's offices, schools, consumer movements, and community organizations. It is affecting not only how institutions organize themselves, but how people relate to each other as they work together for the health of children and families. As one physician has said, family-centered care is "an attitude, not a protocol." Stories included in this issue describe how relationships among providers and families are evolving in family-centered ways. But most important, they profile changes that are bringing new hope and promise to the lives of individual children and their families.
Out of these experiences, we are learning a number of important lessons that can help family-centered systems to grow wherever professionals and families are committed to change. For example, we now know that:
- Respecting children and families by asking them what they actually experience and what they really need is the beginning of positive change.
- Honest assessment of existing services and a willingness to address the priorities that families identify is the first step in the process of developing policies and programs that will best serve children and families.
- Organizations that clearly articulate core values and use a broadly collaborative process to identify and foster those values are more likely to support the concepts of family-centered care and to succeed in implementing them.
- Leaders make a big difference. While change can bubble up from inside an organization, it is faster and lasts longer when senior leaders are behind it.
- Change is hard, sometimes even threatening. Family-centered change requires persistence, patience, creativity, and vision.
- Change does not happen overnight. Successful family-centered change takes place step by step over a long period of time and is a process that is never finished.
- No one needs to reinvent the wheel. We now have many models for positive change across the service system, and the lessons they have to teach can be broadly applied wherever children and families are served.
At the Institute, we are committed to promoting family-centered change wherever children and families receive services, and we are encouraged by the depth and breadth of the changes we are now seeing at many levels and across disciplines throughout the country. We hope the stories and commentary in this issue will inspire and encourage you in your own journey to improve the lives of all of America's children and their families.
Item No. 32093, Price $8