Towards integrated paediatric services in the Netherlands: a survey of views and policies on collaboration in the care for children with cerebral palsy.
OBJECTIVE
Worldwide, family-centred and co-ordinated care are seen as the two most desirable and effective methods of paediatric care delivery. This study outlines current views on how team collaboration comprising professionals in paediatric rehabilitation and special education and the parents of children with disabilities should be organized, and analyses the policies of five paediatric rehabilitation settings associated with the care of 44 children with cerebral palsy (CP) in the Netherlands.


METHODS
For an overview of current ideas on collaboration, written statements of professional associations in Dutch paediatric rehabilitation were examined. The policy statements of the five participating settings were derived from their institutional files. Documents detailing the collaborative arrangements involving the various professionals and parents were evaluated at the institutional level and at the child level. Involvement of the stakeholders was analysed based on team conferences.


RESULTS
Also in the Netherlands collaboration between rehabilitation and education professionals and parents is endorsed as the key principle in paediatric rehabilitation, with at its core the team conference in which the various priorities and goals are formulated and integrated into a personalized treatment plan. As to their collaborative approaches between rehabilitation centre and school, the five paediatric settings rarely differed, but at the child level approaches varied. Teams were large (averaging 10.5 members), and all three stakeholder groups were represented, but involvement differed per setting, as did the roles and contributions of the individual team members.


CONCLUSIONS
Collaboration between rehabilitation and education professionals and parents is supported and encouraged nationwide. Views on collaboration have been formulated, and general guidelines on family-centred and co-ordinated care are available. Yet, collaborative practices in Dutch paediatric care are still developing. Protocols that carefully delineate the commitments to collaborate and that translate the policies into practical, detailed guidelines are needed, as they are a prerequisite for successful teamwork.
Nijhuis
B J G
BJ
Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. b.j.g.nijhuis@rev.umcg.nl
Reinders-Messelink
H A
HA
de Blécourt
A C E
AC
Olijve
W G
WG
Haga
N
N
Groothoff
J W
JW
Nakken
H
H
Postema
K
K
D002547:Cerebral Palsy / Q000534:rehabilitation*; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D002675:Child, Preschool; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration*; D004519:Education, Special / Q000458:organization & administration; D005190:Family; D005260:Female; D006801:Humans; D008297:Male; D009426:Netherlands; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction; D011368:Professional-Family Relations