Evaluating Family-Centered Care in Florida\u27s Pediatric Medical Home Demonstration Project

An important aspect of health care quality, patient-and family-centered care was studied to evaluate whether the Florida Pediatric Medical Home Demonstration Project’s provider-based model improved the family-centeredness of health care for children served by the participating practices. A longitudinal mixed methods study analyzed annual practice-level surveys, reports and monthly call notes for 15 Florida pediatric primary care practice teams participating in a 12-month Learning Collaborative. Annual telephone survey data collected from Florida parents of children with or without special health care needs enrolled in Medicaid/CHIP who are patients in the demonstration practices or not, were also analyzed. Changes of family-centeredness in the practices were studied using related themes in the Medical Home Index focusing on family feedback, family involvement and family education. Changes in parents’ perceptions of the family-centeredness of care experienced in their child’s medical home were studied using data from CAHPS Patient-Centered Medical Home survey and National Survey of Children with Special Health Care Needs questions focusing on family-centered care. Changes in parents’ perceptions regarding access to a visit summary, experiencing family feedback, family involvement and family education could not be predicted by corresponding changes in their child’s medical home. Variations within and between parent populations nested in those primary care practices could not be predicted by practice-level characteristics. Language spoken at home accounted for some variation. Significant main effects of practice type and child type on parents’ scores regarding provider support in managing their child’s health were observed. No significant interactions were noted for combinations of practice type, child type and/or time for any outcome variables tested. Practices with higher MHI QI domain scores had more qualitative evidence of engaging families in medical home improvement. Research findings add evidence to the literature of facilitators and barriers to consider when working to advance family-centered care quality in pediatric medical homes