Family-centered care (FCC) is a philosophy of care that acknowledges the importance of the family unit as the fundamental focus of all healthcare interventions (Chart 1-1). This model of care

FCC is one of the three goals of the IHI Triple Aim Framework that describes an approach to optimizing health system performance (Institute for Healthcare Improvement, 2014). The three goals are

Improving the patient experience includes developing partnerships with patients and their families, including identifying a family member or other key caregiver that will be supported and developed to coordinate services among the multiple providers of care to the patient (IHI, 2014).

FCC also plays a key role in working to improve health and healthcare quality as outlined in the National Quality Strategy (Agency for Healthcare Research and Quality, 2011). Ensuring that each person and family is engaged as partners in their care and promoting effective communication and coordination of care are two of the six priorities that address common healthcare concerns in the United States.

Pediatrics nurses are instrumental in the successful implementation of these key national initiatives. The nurse is uniquely placed in a role that interfaces with the child, the family, and a broad range of healthcare providers. The nurses’ understanding of the child/family needs, and the nurses’ role as an advocate, educator, role model, and user of evidence-based practice places her/him in a position to lead improvements in the ongoing goal of ensuring FCC is incorporated in all aspects of inpatient, outpatient, and homecare.

FCC is best understood by extracting and explaining the elements or components of this philosophy of care that work together to move an individual or an institution toward providing a family-centered approach (Chart 1-2). In pediatric healthcare, the elements of FCC recognize each family’s uniqueness, acknowledge the influence of the family as a constant in the child’s life, and emphasize the importance of providing services that demonstrate the value of collaboration between the healthcare provider, the child, and the family. FCC is based on the premise that a positive adjustment to a child’s level of health and well-being requires the involvement of the whole family (American Academy of Pediatrics, 2012a; Coyne, O’Neill, Murphy, et al., 2011; Institute for Patient- and Family-Centered Care, 2010; National Center for Family Professional Partnerships, 2012). Jolley and Shields (2009) point out that, although FCC is believed by most practitioners to be the best way to deliver care to children, in many cases, FCC may not be implemented effectively. In some cases, when poorly implemented, parents may feel they are doing all of the work of the healthcare providers. It is imperative that a consistent approach to FCC is understood by all healthcare providers in a setting and that policies and procedures reflect the principles of FCC.

FCC is a philosophy of care that must be translated into action. The relevance to the child and the family goes unnoticed unless active measures are taken to ensure
that family-centered practices are integrated into every aspect of the healthcare arena. From legislation supporting family-centered practices to an interdisciplinary team focused on the needs of the entire family, the elements of FCC can be operationalized through a variety of unique strategies (Chart 1-3). These family-centered strategies need to continue to be described in the healthcare literature, noting exactly which strategies have been truly effective in meeting family needs (AAP, 2012b). In the same manner, healthcare providers need to continue to assess family needs, document how FCC has been implemented, define factors that facilitate or hinder FCC, and document the cost-effectiveness of FCC.