Allen I. Goldberg

Home care for life-supported persons: an approach to program development.

Eighteen ventilator-dependent children were returned to their homes from Illinois. Each candidate was selected according to physician-designated guidelines for medical stability as well as predetermined social-environmental and reimbursement criteria. Each individualized occurrence was organized according to a comprehensive home care plan. Unanticipated improvement in medical condition and psychosocial development has resulted at home. The children and families have returned to a safe environment that best promotes the health of all involved. In addition, initial cost savings were at least 70%. These demonstrations have evolved into an organized regional approach to the ventilator-dependent child which utilizes available resources. The required continuum of health care and personal services includes intermediate intensive care, respiratory rehabilitation, transitional care, home care, and community-oriented alternatives to home. Problems of the ventilator-dependent child are those encountered by all children with handicaps and their families. The appropriate solutions will provide models for other complex health care and societal issues.

Quality of Care for Life-Supported Children Who Require Prolonged Mechanical Ventilation at Home

Home care is now possible for ventilator-dependent children. It is crucial, however, to ensure that the childrens conditions are medically stable and that their home care is carefully planned before they are discharged. The Ventilator-Dependent Discharge Program at Childrens Memorial Hospital in Chicago uses a comprehensive, multidisciplinary approach to discharge planning. The program includes training for parent caregivers, organization of community resources, and arrangement for funding.

Pediatric home care for chronic respiratory insufficiency

EDIATRIC HOME care for children P with chronic respiratory insufficiency has been safely accomplished for over a decade. To provide quality programs in a cost-effective manner for oxygenand ventilator-assisted children, a home care program must be developed, implemented, and managed based on these philosophies: the child must be medically stable, each program must be designed to meet the individual needs of the child and his or her family, and quality assurance must be the primary goal with cost containment an