Houston Project DOCC
Children who have chronic/long-term illnesses or severe disabilities have complex needs that can make the healthcare system difficult to navigate. As doctors are traditionally trained to focus only on the medical situation, they may be unaware of the day-to-day issues in the lives of families with children who have significant needs. In 1994, parents in New York state developed Project DOCC (Delivery of Chronic Care) as a family-centered and community-based pediatric training program designed to increase doctors’ awareness and understanding of the complex issues associated with caring for medically involved children.
Train and then match parents with pediatric and family practice residents in Houston to expand doctors’ skills in delivering family-centered care.
Project DOCC Houston recruited, trained, and assigned duties to 37 parent teachers. The staff of Project DOCC and the parent teachers worked on the Project DOCC training components together. “Back-up” parent teachers and medical professionals were also scheduled in case an assigned parent teacher could not participate due to an ill or hospitalized child.
All Baylor University pediatric residents were scheduled for the Project DOCC training components, with class sizes ranging from 48 to 52. Project DOCC home visits and parent interviews were scheduled as part of the Pediatrics 101 curriculum during the first month of the class. Pediatrics 101 involved groups of three residents completing two-week rotations. The residents visited various community programs and gave lectures on certain topics. Since the schedule was set as part of a curriculum, Project DOCC had a very high rate of participation.
Project DOCC Houston presented 13 grand rounds panel presentations (GRPPs) to pediatric residents and to social work graduate students from local universities and at the Transitioning from Pediatric-Based Medicine to Adult-Based Medicine Conference. A GRPP for the Department of Pediatrics, Baylor with the medical faculty and staff had over 125 people in attendance and approximately another 100 watching via closed-circuit television.
The Program Director was invited by the Chief Resident of the Department of Pediatrics, Baylor to lecture to the residents during the “Noon Talks” at Ben Taub Hospital and Texas Children’s Hospital (TCH). She also presented on “Developing a Family Faculty Program – Project DOCC” at a number of national conferences.
The Resource Guide for Parents of Children with Disabilities, Houston and Surrounding Areas, along with information on the Medical Home concept and the principles of Family-Centered Care, were provided for all the pediatric residents. The Program Director also provided this information in English and Spanish during her presentations on Project DOCC Houston to the parent groups.
Project DOCC Houston was also represented at Houston-area advisory and networking groups. The Program Director and Project Coordinator presented to the TCH Family Advisory Board members on “Telling Your Stories” and have assisted the members in writing their stories for a book to be published by TCH on applying the principles of family-centered care.
- 37 parent teachers were recruited, trained, and assigned duties with pediatric residents
- 13 GRPPs were presented
- After participating in Project DOCC, residents were more likely to believe that parents of children with chronic illness/disability should have an active and equal role with physicians in making all decisions related to their children’s care
- A majority of the residents indicated that participation in Project DOCC had made them more willing to work with children with chronic illness/disabilities and their families
- Residents reported an increase in their perception of their knowledge, understanding, familiarity, and ability to assist with many facets of life for families caring for children with chronic disabilities