Congratulations to Ryan Coller, MD, MPH, Mary Ehlenbach, MD, and Kristan Sodergren, NP, of the Pediatric Complex Care Program (PCCP) on two recent one-year awards funded by the Children’s Health Alliance of Wisconsin’s Advancing Family-Centered Care Coordination for Children and Youth with Special Health Care Needs using a Shared Plan of Care (SPoC) program.
The first grant, titled “Shared Plan of Care (SPoC) – 2020 SMARTer Goals,” in the amount of $20,000, led by Mary Ehlenbach and Ryan Coller, will build on work from a recent grant which developed and piloted Shared Plans of Care for all children enrolled in the PCCP. The team will continue to refine the development, implementation, and updating process for SPoCs with a focus on making them more user-friendly. More specifically, this year’s focus will involve the use of “goal cards,” seeking to improve the ability of patients and families who are enrolled in the PCCP to choose goals that are meaningful to them and impactable by the team during care planning visits.
A second award, entitled “Youth to Adult Transitions SPoC,” for $25,000, will be led by Kristan Sodergren and Ryan Coller. Transferring care for children with medical complexity from pediatric to adult healthcare systems is a daunting task for youth, families and clinicians. This project will build upon last year’s work and continue to refine the development, implementation and documentation processes involving the PCCP youth-to-adult transition education efforts. This year’s focus will include piloting two initiatives: 1) “goal cards” at clinic visits, aiming to promote the consideration of a wide array of unique, actionable goals by patients and their families during goal setting; and 2) inclusion of a “Hopes and Dreams” section in each child’s shared plan of care (SPoC).