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St. Luke's Dr. Greg Janos: Valuing Partnerships to Enhance Care for Children

By Dr. David C. Pate, News and Community
September 16, 2014

As a specialist in internal medicine, I have often said in explaining what that is that I take care of "big kids.” 

That really is not a proper analogy. Adults are not simply big kids. Dr. Janos, our executive medical director of St. Luke's Children's Hospital, gives five ways that caring for children is different from caring for most adults, and I completely agree. That approach is one of the many reasons that I am so proud that St. Luke's offers such high-quality pediatric and pediatric specialty care.

As today's guest blogger, Dr. Janos explains what patient- and family-centered care is. That’s a strategic priority for St. Luke's, and although implemented differently, it means the same thing in caring for children and "big kids" alike. Here is Dr. Janos:

“Happiness is having a large, loving, caring, close-knit family in another city." – George Burns

George must have been remembering some of those interesting and challenging family Thanksgiving gatherings that many of us have also experienced. However, in principle I couldn’t disagree more.

I think frequently about the “four Ds plus one,” those aspects of children’s health care that differentiate pediatric medicine from the adult world of care: developmental status and change; differential epidemiology in their patterns of health and illness; dependence on adult caregivers; demographic patterns; and complexities and special healthcare needs.

One of the most significant is dependency — the fact that most of our patients are dependent upon “family” for the planning and provision of care. Children depend upon adults for timeliness, coordination, and completion of care. It is important to note that by “family,” I mean not just relatives but all those involved in children’s care.

One of the crucial elements for ensuring our success in transforming health and achieving our Triple Aim is how well we are able to engage and involve family members in the health care of their loved ones. This is the basis of one of St. Luke’s Children’s core values: Patient- and Family-Centered Care (PFCC).

The basic precepts as provided by the Institute of Patient- and Family-Centered Care are:

  • Respect, recognizing that each and every family is different, with unique compositions, history, cultural, and ethnic diversity to be considered in the formulation of each and every care management plan.
  • Strengths, identification of the individual strengths of each family and its members that may be leveraged to maximize effectiveness and efficiency of care.
  • Choice, transparency of information and the understanding that each family and patient ultimately have a choice of care plan for their loved one.
  • Flexibility, the ability for the family/provider partners to remain flexible for changes in the approach to care and in the use of additional resources when appropriate and available.
  • Information, sensitivity to the level and scope of information that we as providers are sharing and openness to consider information brought forth and shared by family members.
  • Support, comprehensive support by providers for not only the physical needs of the patient and family but for their other needs (e.g., mental, spiritual, financial, etc.) as well, and support by the families for the policies and procedures, rules and regulations of the institutions that guide clinical care.
  • Collaboration, with the care plan effectively a contract to be developed in partnership by the family and care provider team. Each partner will agree to be held accountable for their role in the care plan.
  • Empowerment, enabling the patient and family to assume a greater role in care and a greater level of responsibility for outcomes.
St. Luke’s success in transforming health care will depend greatly upon the depth and extent of our multiple partnerships, those current and those we will forge in the future. These include partnerships between providers and health system and between health system and  community members and organizations.

None will be more crucial to our future success than the partnerships created between patients/families and providers and the health system. There are few areas, if any, where patient and family participation and collaboration will not be an essential part of our journey. That includes developing and conducting quality and safety initiatives, improving access to care, and planning and designing our campus and facilities.

I’m glad to be part of this meaningful discussion as we build stronger, ever more meaningful partnerships between St. Luke’s and the patients we serve.

About The Author

David C. Pate, M.D., J.D., previously served as president and CEO of St. Luke's Health System, based in Boise, Idaho. Dr. Pate joined the System in 2009 and retired in 2020. He received his medical degree from Baylor College of Medicine in Houston and his law degree from the University of Houston Law Center.