Framework Approach

Our approach to promoting evidence-based, and culturally responsive best practice child-friendly healthcare stems from a culmination of collected research and decades of hands-on experience working with patients and families around the globe. The Pediatric Patient's Hierarchy of Developmental Needs (PPHDN) © framework suggests that patient coping can be supported much like building blocks with fundamental elements supporting more complex processes.

PPHDN LEVEL

Physiological Needs

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Related Skills and Services

Beds, food, medication, physical comfort, opportunities for restful sleep

Parental presence

Support measures

Recognition that children are not miniature adults

Organizational Potential

Resources and evidence related to benefits of pain management initiatives.

Parental presence policies/guidelines and integration of evidence related to the benefits of parental presence.

Safe space initiatives, procedure/treatment rooms, evidence related to benefits of the use of comfort positions and treatment rooms.

Tools and resources that are appropriate for pediatric patients (e.g. mask and intravenous line sizes appropriate for children’s bodies).

Collaborative Tasks

Identify opportunities to provide evidence based training regarding pain management initiatives (e.g. pharmacological and non-pharmacological).

Partner with administration regarding mission and vision to include family centered care, provide education to staff regarding parental presence and participation practices and benefits.

Provide evidence-based education and research to support the development and use of treatment rooms and comfort positions.

Identification of the potentially negative impact of generalizing medical equipment and care to children from adult resources.

PPHDN Level

Environmental Needs

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Related Skills and Services

Positive, supportive environment

Culturally responsive care and caregivers

Facility free from undue stress

Organizational Potential

Environmental design support based on culture and resources available.

Mission and vision, policies and guidelines that support diversity across all spectrums (e.g. gender, race, religion).

Risk management strategies to minimize patient injury and model optimal safety initiatives.

Collaborative Tasks

Provide research and guidance regarding the influence of environment and identify achievable projects (e.g. treatment room, playroom).

Provide education regarding the impact of diversity on caregiving outcomes.

Provide evidence-based education and research to support the development and use of treatment rooms and comfort positions, education regarding the impact of developmentally supportive language on patient experience of fear (e.g. if you don't behave, I'll give you a shot).

PPHDN Level

Cognitive Needs

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Related Skills and Services

Education about illness and treatments, preparation and support for procedures

Culturally responsive research to drive applicable evidence-based practices

Clinically trained staff to provide developmentally appropriate services to patients

Organizational Potential

Development of a psychosocial care vision to promote organizational culture shift.

Infrastructure to support psychosocial research.

Development and implementation of a psychosocial role within the organization to provide appropriate assessment, education, procedural support and reinforce coping outcomes.

Collaborative Tasks

Development of culturally responsive, patient and family centered, concrete educational tools that staff can use in absence of a psychosocial staff person including education regarding techniques to maximize patient coping through knowledge and empowerment (e.g. reward charts, care schedules, choice making, and interactive learning).

Research study design and analytics support to identify useable outcome metrics.

Assistance with budgeting for position development, and relevant Human Resource policies and procedures such as job descriptions.

PPHDN Level

Social Needs

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Related Skills and Services

Safe play space

Family support

Opportunities to engage with others

Organizational Potential

Commitment to the development and support of play spaces and play opportunities.

Parental presence policies/guidelines and integration of evidence related to the benefits of parental and family presence.

Development and implementation of a psychosocial role within the organization to facilitate opportunities for social engagement whether in a playroom space with other patients, in a multi patient treatment setting or through engagement with special event type visitors.

Collaborative Tasks

Environmental design consultation for the development of social spaces, education regarding culturally responsive therapeutic relationships and professional boundaries.

Partner with administration to develop and implement culturally responsive patient and family centered care practices.

Cultivation of organizational and community partners to support the resources necessary to sustain appropriate clinicians and the tools necessary to fulfill the roles.

PPHDN Level

Participatory Needs

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Related Skills and Services

Developmentally appropriate education and information to voice choices about healthcare options

Community support and engagement

Legacy needs

Organizational Potential

Commitment to the development and support of a psychosocial care team.

Commitment to engaging community resources that seek to support optimal outcomes and functioning for patients and families.

Development of a palliative care and bereavement care philosophy reflective of cultural and religious beliefs.

Collaborative Tasks

Provide evidence indicative of the positive impact on psychosocial care teams, support the development of a psychosocial care team and provide evidence and best practice information regarding the positive impact of comprehensive care on patient outcomes.

Identification of and facilitation of partnership with appropriate community organizations.

Provide education and skills training about legacy activities, techniques and support services.