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Improving health care for children with special needs

HANOVER, NH Health care delivered close to home is vitally important, especially when the patient is a child. But how do community pediatric practices adapt to offer the best care when faced with a child who has complex and often, multiple health needs? Reporting in this month's issue of Pediatrics, Dartmouth researchers outline a process designed to help any practice become a state of the art "medical home" for such children.

Assessing the effectiveness of a model program they developed, Dartmouth Medical School researchers Dr. W. Carl Cooley, adjunct associate professor in pediatrics, and Jeanne McAllister, research associate in pediatrics, review the experience of four practices in Vermont and New Hampshire who used their program to identify and implement changes to improve the care they deliver to children with special health care needs.

The concept of community-based "medical homes" places where care is managed through coordination of clinicians, educators, therapists, healthcare professionals, and caregivers has been advocated by national health policy makers and the American Academy of Pediatrics as the best model for providing systematic yet individualized care to children with complex conditions and multiple needs.

Still, the changes required for a practice to become an effective medical home can be difficult to make. "Introducing change into a busy pediatric practice is like trying to repair a bicycle while riding it," the authors write. "Even the most motivated practice finds change difficult to implement. Many primary care providers believe that implementing the medical home concept is the right thing to do but question how they can do so and remain solvent."

To make the process easier, the authors developed a medical home improvement tool kit that allows practices to look at key functions of the medical home, assess their own operation, and identify the steps and strategies they will follow to become a medical ho
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Contact: Andy Nordhoff
MedNews@dartmouth.edu
603-653-1969
Dartmouth Medical School
20-May-2004


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