Supplements

Advocacy

Copyright © 2010 Society of Hospital Medicine

Introduction

Advocacy is defined as the process of speaking out in support of a specific individual, cause or program as distinct from the direct provision of material support to the individual, cause or program. In pediatric hospital medicine, advocacy can occur as an isolated event for a single patient, but is most effective when it leads to a change in an approach to a problem that supports multiple individuals in similar circumstances. Advocacy skills are part of the toolkit of both physicians and leaders. In conjunction with other healthcare professionals and organizations, pediatric hospitalists have an important role to play in advocating for both the children and the evolving field of hospital medicine. Pediatric hospitalists may also be called upon to advocate for the pediatric services or department within the hospital, as well as for children in the community.

Knowledge

Pediatric hospitalists should be able to:

  • Define advocacy and health policy.

  • Describe how advocacy impacts the care of children both in the hospital and the community.

  • Discuss the multiple levels of advocacy, including individual, group, institutional, community, and legislative advocacy.

  • Illustrate how financing of child health relates to advocacy.

  • Describe the relationship between pediatric quality and advocacy.

  • Discuss the various areas of focus for advocacy efforts, including disease process/diagnosis, age group, socio‐economic, cultural or demographic group, health systems, payment systems, and government or community agencies.

  • Describe the legislative process and identify specific ways in which physicians can participate in this process to improve the health of children, especially those requiring hospitalization.

  • List the key national organizations (such as the American Academy of Pediatrics, the Society of Hospital Medicine and National Association of Children's Hospitals and Related Institutions and others) with which pediatric hospitalists work to advocate for hospitalized pediatric patients

  • Explain how private and governmental funding and oversight organizations (such as Leapfrog, Medicaid, The Joint Commission and many others) influence advocacy efforts for children's healthcare.

  • Identify community characteristics, demographics, needs, and assets that impact children's healthcare, including the availability of social, educational, and medical services for children and the family/caregiver.

  • State common barriers, especially those unique to the pediatric population, that impact hospital care for children.

  • Cite advocacy efforts that are unique to community hospitals such as obtaining pediatric representation on key committees, establishing a relationship with a pediatric referral center, and developing relationships with adult subspecialists.

  • Cite unique opportunities for advocacy in children's hospitals.

  • Define the medical home and understand the role of pediatric hospitalists in delivering care within a medical home.

Skills

Pediatric hospitalists should be able to:

  • Conduct effective family centered, interdisciplinary rounds.

  • Consistently engage patients and the family/caregiver in medical‐decision making.

  • Deliver family‐centered, comprehensive, coordinated care for medically complex children and other special populations.

  • Develop collaborative relationships with other pediatric healthcare providers to advocate for children within the medical home model.

  • Provide effective media interviews on relevant topics in various formats (such as print, radio, television, and other).

  • Define, articulate, and gain support for the unique health care needs of children in the hospital setting as well as the community.

  • Identify hospital environments or processes that lack a focus on children and take appropriate steps to advocate for pediatric‐specific needs.

  • Participate in the advocacy and health policy activities sponsored by local, community, and national organizations.

Attitudes

Pediatric hospitalists should be able to:

  • Accept responsibility for child health advocacy.

  • Recognize the cultural beliefs and biases of patients, family/caregiver, and healthcare providers and adapt to advocate for patients' needs.

  • Realize that the most effective advocacy involves creation of coalitions and teams.

  • Maintain awareness of political, cultural, and socio‐economic factors affecting children's healthcare and the practice of pediatric hospital medicine.

Systems Organization and Improvement

In order to improve efficiency and quality within their organizations and their communities, pediatric hospitalists should:

  • Incorporate the institution's mission and vision statements into daily work.

  • Work with key hospital leaders to assure child advocacy is fully integrated into the delivery of care on a daily basis.

  • Establish effective relationships with hospital leaders, community leaders and local politicians to target a specific issue and/or serve as an expert pediatric consultant.

  • Participate in the development of systems of care in your institution and beyond that promote effective care for hospitalized children.

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