Partner with Families in Care and Practice Transformation

Partner with Families in Visits

Bright Futures recommends starting every visit with assessing and commending family strengths and eliciting family concerns. 

Assess and commend family strengths questions.

• Strengthening Families and Action Sheets
• Healthy Outcomes from Positive Experiences (HOPE).
• Identifying Risks, Strengths, and Protective Factors from Learn The Signs. Act Early.
• Documenting Early Relational Health in Patient Charts
• Eliciting Family Strengths in Infant Visits Scripts

Family concerns - scripts, prompts, and dot phrases during the visit.

• What Matters to You - making a patient feel part of the process and prioritizing their thoughts, needs, and concerns — is part of the healing process.
• The “New Mexico Three” asks 1) Has anything major (traumatic, etc. - use your own terms) happened since the last time we've met? 2) If so, how has it had an impact on you and your family (again, whatever scope is appropriate)? and 3) Despite that, what's been going well for you?
• Asking Social Drivers of Health (SDOH) Questions
• AAP Early Brain Child Development (EBCD) 1,000 Days

Transform the Medical Home

Develop opportunities to involve front desk staff in practice improvement efforts.  

• Seek trainings for all staff that promote strong relationships with families such as utilizing strengths-based approaches, cultural humility, motivational interviewing, etc.  
  • Common Factors approach for strengths-base communication  
  • Infant and Early Childhood Mental Health: Relational Foundations for Lifelong Health | shopAAP
  • FAN: Relational Practice through Attunement
• Front desk staff can also support pre-visit planning. For example, if your team utilizes registries to track families with complex needs, they can work to support their needs through scheduling (longer visits, same provider) and/or preparing the environment (dimming lights, providing sensory items).
  • Team Planning Sheet.

Create a comfortable and family-friendly space.

• Poster and handouts on developmental promotion in the waiting room with representation.
• Materials like books and brochures representative of communities served by the practice.

Create a space for Reflective Practice for staff and family leaders.

• Provide formal, dedicated time for reflective supervision either in a small group or embedded in administrative supervision to create an open environment.
• Utilize Facilitating Attuned Interactions (FAN model)

Establish and utilize warm hand-offs with key partners.

Ensure family engagement in the referral process. 

• Teach-back and Ask Me Three strategies can support this by asking families to repeat back need steps and ensure understanding and alignment.

Support families with referral navigation.  

• The Family Friendly Referral Guide is a simple guide that can be filled out with families so they are aware of and confident with next steps.
• Elicit feedback from families on referrals.  Responses from families could support adjustments such as providing additional resources or guidance prior to the referral, connecting with the referral partner and adjusting on their end, and identifying other services that may better meet patients’ needs. 
• Create a system to identify and track risk factors, so families receive continuous and coordinated care.  How to Identify and Track Developmental Needs
• Share community resources and family focused apps and education materials with all families.
  • Miss Shayla’s Family Support List
  • Milestone Tracker 
  • Sesame Street Workshop (Elmo Belly Breathing, Bubbles, Monster Calm) 
  • Vroom Brain Builder 

Families of color have unique live experiences and perspectives. Learn practice changes and care improvement resources:

• Watch and learn from
  • Ted Talk on Allegories on Race with Camara Jones, MD, MPH, PhD
  • Why Race Matters from Tiffani Johnson, MD, MSc, FAAP and slides
  • Bias in Communication from Tiffani Johnson, MD, MSc, FAAP Family-centered discussions, counseling, and workflow resources:
• Take and reflect on your results from Harvard University Implicit Association Test
• Discuss what practices changes can be made to implement recommendations from The Impact of Racism on Child and Adolescent Health. Engage families to understand their perspectives and areas they see for improvement in your office environment and practice policies.
• Continue to learn about racism and equity approaches with these resources and discussion guides AAFP EveryONE Toolkit and George Washington Community Resilience Toolkit 

Engage Family Advisors

Family engagement is an integral approach to the planning, delivery, and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers, patients, and families.

Pediatricians often talk with their patients about social drivers of health, infant and child mental health, and other complex and chronic health care needs. These conversations can be sensitive and raise questions around confidentiality, community referral services, health equity, and more. Family advisors can help practices address the best way these questions can be posed to families and develop solutions together. Additionally, their experiences and expertise make them the perfect partners to bridge the gap between community and clinical services.

Create a goal for working with families and develop a policy that captures it

• Information for developing a policy for family engagement
• Policy Guide
• Family engagement policy template
• Family Leader Role Description Template

Assess the level of family engagement at your clinic or in your state system. Family Engagement in Systems Assessment Tool (FESAT) 

Best Practices for Identifying, Engaging and Sustaining Family Advisors
This guide, developed from participants of the AAP Addressing Social Health and Early Childhood Wellness grant, includes a wide variety of information to help practices engage family advisors in their work.

The guide includes the following information:

• What are family advisors
• Benefits of engaging family advisors
• How to overcome common obstacles
• Success stories
• Sample job descriptions for family advisors
• Sample promotional material for recruiting family advisors
• Sample mission statement
• Examples of tasks for family advisors
• A step-by-step guide to identify, engage, and sustain family advisors

Watch this short video on engaging family advisors in your pediatric practice and then, using the links below, review the 3 steps in the family advisor guide along with the additional resources.

•  Step 1: Develop Infrastructure for Supporting Family Advisors
• Step 2: Select Family Advisors
• Step 3: Ensure Success with Your Family Advisors

Family Advisor Success Stories
Three success stories of engaging family advisors that were gathered during the ASHEW grant. The areas of success include: (1) creating a family advisor panel, (2) bridging the gap between the practice and community partners, and (3) improving the screening process.

Common Obstacles of Family Advisor Engagement and Strategies to Overcome Them
Participants of the ASHEW grant shared a variety of obstacles while engaging family advisors and strategies to overcome them to ensure success.

Family Advisor Job Description Quality Improvement
Template of a family advisor job description with a focus on quality improvement. The information is this job description is meant to be edited and tailored to the needs and expertise of your family advisor(s) and your practice.

Family Advisor Job Description Community Partnership
Template of a family advisor job description with a focus on creating community partnerships. The information is this job description is meant to be edited and tailored to the needs and expertise of your family advisor(s) and your practice.