Care maps and care plans for children with medical complexity

Sherri Adams; David Nicholas; Sanjay Mahant; Natalie Weiser; Ronik Kanani; Katherine Boydell; Eyal Cohen

doi:10.1111/cch.12632

Care maps and care plans for children with medical complexity

Child Care Health Dev. 2019 Jan;45(1):104-110. doi: 10.1111/cch.12632.

Authors

Sherri Adams^{1

2

3}, David Nicholas⁴, Sanjay Mahant^{1

3

5}, Natalie Weiser¹, Ronik Kanani^{6

5}, Katherine Boydell^{7

8

9}, Eyal Cohen^{1

3

5}

Affiliations

¹ Division of Paediatric Medicine, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
² Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
³ Child Health Evaluative Sciences, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁴ Faculty of Social Work, University of Calgary (Edmonton Division), Edmonton, Alberta, Canada.
⁵ Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
⁶ Maternal, Newborn and Paediatric Care Program, North York General Hospital, Toronto, Ontario, Canada.
⁷ Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia.
⁸ Child and Youth Mental Health Research Unit, The Hospital for Sick Children, Toronto, Ontario, Canada.
⁹ Dalla Lana School of Public Health, Universality of Toronto, Toronto, Ontario, Canada.

PMID: 30462842
DOI: 10.1111/cch.12632

Abstract

Introduction: The support of families in the care of children with medical complexity (CMC) requires the integration of health care providers' (HCPs') medical knowledge and family experience. Care plans largely represent HCP information, and care maps demonstrate the family experience. Understanding the intersection between a care plan and a care map is critical, as it may provide solutions to the widely recognized tension between HCP-directed care and patient- and family-centered care (PFCC).

Method: This study used qualitative methods to explore the experience and usefulness of care maps. Parents of CMC who already had a care plan, created care maps (n = 15). Subsequent interviews with parents (n = 15) and HCPs (n = 30) of CMC regarding both care maps and care plans were conducted and analyzed using thematic analysis.

Results: Data analysis exploring the relationship and utility of care plans and care maps revealed six primary themes related to using care plans and care maps that were grouped into two primary categories: (a) utility of care plans and maps; and (b) intersection of care plans and care maps.

Discussion: Care plans and care maps were identified as valuable complementary documents. Their integration offers context about family experience and respects the parents' experiential wisdom in a standard patient care document, thus promoting improved understanding and integration of the family experience into care decision making.

Keywords: care maps; care plans; medical complexity.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Attitude of Health Personnel
Canada / epidemiology
Child
Child Health Services / organization & administration*
Delivery of Health Care / organization & administration*
Female
Health Personnel
Health Services Research
Humans
Male
Multiple Chronic Conditions / epidemiology
Multiple Chronic Conditions / psychology
Multiple Chronic Conditions / therapy*
Needs Assessment
Parents / education
Parents / psychology*
Patient Care Planning / organization & administration*
Patient-Centered Care / organization & administration*
Professional-Family Relations
Qualitative Research