Keywords

care coordination, care fragmentation, children with medical complexity (CMC), chronic conditions, goal planning, Iowa Model, Triple Aim

Authors

1. Lindstrom, Kathy DNP, APRN, FNP-BC
2. Cady, Rhonda PhD, RN
3. Bushaw, Andrea PhD, RN, CPNP

Abstract

Abstract: NPs piloted a family-centered goal-planning tool with a medically complex pediatric population during outpatient clinic visits. The tool was an effective reminder to discuss goals after trust and rapport are established between provider and family.