Communication, collaboration, caring: the three C's of family-centered care.

The National Perinatal Association's policy statement defines family-centered perinatal services as "those which recognize and cultivate the strengths of families and respect their concerns, attitudes, values and ethics. This model recognizes that the efforts of health care providers support the work of families and communities who contribute the primary resources, support and dedication to their children. In a family-centered model, families and health care providers form partnerships for the purpose of developing, implementing and evaluating perinatal health services."

Family-centered care has been available since the early 1970s in many parts of the country. Although not every hospital practices family-centered care at this time, many attempt to implement some or all of its concepts.

Family-centered concepts

Perinatal outcomes can be improved by addressing all aspects of perinatal health, including the medical, emotional and psychosocial needs of families and their babies. The National Perinatal Association believes that family-centered policies and practices should begin "pre conception" -- when couples are only thinking about having a baby and continue through birth and post-partum, and include the first year of the baby's life.

Communication, collaboration and caring are three of the most critical aspects of the many components of a family-centered perinatal system of care.

* Communication: families and health care providers must develop a mutual respect and understanding so they can openly exchange ideas, issues and concerns with each other.

* Collaboration: families and health care providers must work together to support informed decision-making. This process emphasizes the family's unique knowledge of their priorities and what could be the consequences of their choices and actions on the family unit, while also recognizing the special professional expertise of the health care providers.

* Caring: families and health care providers must recognize each other's concern about, interest in and love for the special baby the parents have brought into this world. This includes the recognition that the health care providers as well as the parents want to do all they can for this baby.

In order for communication, collaboration and caring to be effective, each family and health care provider must be encouraged to identify, prioritize and share their issues and concerns.

Resolving Conflicts

Unfortunately, despite best intentions of all concerned, a fourth "C" sometimes enters the picture: Conflict

If conflict about the baby's care arises between the family and the health care providers, it must be resolved as quickly as possible. This can be handled through the intervention of an impartial third party or by a higher authority within the health care system.

Most hospitals have a system for resolving conflicts. Usually, conflicts related to the baby's care are handled within the health care team. If necessary, the chief physician of the neonatal section and the care-center manager could be called upon to assist. These physicians and nurses are available to help the families and staff members when needed. Additionally, the chief administrator of the hospital is always available to listen to and guide the family in the resolution of a conflict.

Hospitals and health care providers are there to serve the health needs of individuals and of families. Families should never feel that their concerns have not been heard or understood, and should be encouraged to follow through until a satisfactory resolution has been reached.