When a child has multiple specialists involved in his care, he may need someone to watch over his care who is familiar with the hospitals and staff. At University of Iowa Children's Hospital, there is a program called the Continuity of Care Program that does just that.
Janine Petitgout, RN, ARNP, and director the Continuity of Care Program , talks about the program and how it works:
Explain how the Continuity of Care Program works for families. Who is eligible for the program?
The Continuity of Care Program offered at the University of Iowa Children's Hospital is for children with special health care needs. Anyone from birth to 21 years of age with a diagnosis or a condition that lasts at least 12 months or has multiple services involved is eligible. The Continuity of Care Program assists children and their family by providing service coordination, consultation, resource, and referral assistance.
We facilitate communication between UI Children's Hospital, subspecialty clinics, community providers, and other various disciplines. This program enhances and complements the current discharge planning, such as improving communication and smoothing this transition for the child from hospital to home.
How do patients get involved in the program?
There are several ways:
- Self-referral by calling us. Parents can get information on the Web site.
- Be a patient at Children's Hospital
- Referral by physician, resident, social work referral or any other discipline
In your role as a nurse practitioner, what do you do to assist young patients and their families?
We are the point of contact for these families, kind of the gatekeeper so that the patients and their families have one contact when they have issues or questions that arise with their child.
- We meet with the families and help identify their needs, such as home- and community-based waivers, connections with community support such as WIC (Women Infant Children) and DHS Department of Human Services).
- We facilitate and lead multidisciplinary care conferences as needed
- We serve as a liaison and an advocate for the patient
- We help identify the need for home nursing support
- We assist with identification of supply companies
- We support groups and any other resources that may be needed upon discharge
- We manage phone triage
At what point do you become involved with a patient and family?
When we obtain a referral is when we get involved. We screen the patient and make sure that he meets the enrollment criteria and then we schedule a time to meet with the patient and his family.
We like to obtain referrals upon admission so we have time to follow the patient through his hospitalization and establish a relationship with him. We also can meet the parents and the patient in the clinic as well.
Is program strictly for inpatients?
No, this program is for inpatients and/or outpatients served at University of Iowa Children's Hospital. If they're an inpatient, we meet with them during their hospitalization. If they're out patient, we can see them during a clinic appointment.
If someone would like more information about enrolling their child, how do they do that?
They can check out our Web site or call us at 319-356-4107. |
