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. 2018 Oct 9;21(10):1414–1435. doi: 10.1089/jpm.2018.0056
Defining criteria Critical Moderate Not important
A comprehensive, person-centered interdisciplinary assessment (as described in “Structures and Processes of Care”) identifies the social strengths, needs, and goals of each patient and family to maximize patient–family strengths and well-being. 1 2 3 4 5 6 7
The specific needs of the sibling(s) are assessed and addressed. 1 2 3 4 5 6 7
The plan of care addresses the school environment and considers advance care planning, which may include but not be limited to DNR orders in a school setting; interacting with school nurses, educators, and classmates; DME at school; transportation. 1 2 3 4 5 6 7