The Pediatric Patient's Hierarchy
of Developmental Needs©
Central to the Pediatric Patient's Hierarchy of Developmental Needs (PPHDN)© framework is the concept of thinking of the child and family as an ecosystem.
The idea is that the features effecting healthy development and functioning are best understood through examining the intersection of biological and social influences.
Framework Approach
PARTICIPATORY NEEDS
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 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
Identification of and facilitation of partnership with appropriate community organizations.
Provide education and skills training about legacy activities, techniques and support services.
SOCIAL NEEDS
Related Skills and Services
Safe play space
Family support
Opportunities to engage with others
Organizational Potential
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
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.
COGNITIVE NEEDS
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
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
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.
ENVIRONMENTAL NEEDS
Related Skills and Services
Culturally responsive care and caregivers.
Facility free from undue stress.
Organizational Potential
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 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).
PHYSIOLOGICAL NEEDS
Related Skills and Services
Parental presence.
Support measures.
Recognition that children are not miniature adults.
Organizational Potential
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
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.
OUR STRATEGY
Our evidence-based strategy may utilize a combination of knowledge exchange, collaborative research, staff education and training, psychosocial service development, environmental design consultation, and resource fostering to facilitate project management for proposal development individualized to our partners' growth potential.
We consider our progress in relation to the success of our global partners, and their ability to provide sustainable support systems for the children and families in their care.
During initial site visits to partner hospitals/pediatric units, we identify organizational strengths and recommend areas for psychosocial care enhancement in addressing patients’ needs through each level in the PPHDN© , and then collaboratively develop a customized work plan.
Once recommended areas for psychosocial care enhancement have been addressed, we re-assess our partners' capacity to provide sustainable support systems for the children and families in their care by utilizing the PPHDN© .
