Why implementing family-centered care is like making home-made pasta

You can do a good job practicing family-centered care (FCC) without any special tools, but with the right tools, you can do it much better!

Just like a great home-made pasta is a fantastic way to get the family together for dinner, how can we get the family to come together during audiology visits?

“Making pasta?”, I hear you ask. Well, yes, it may seem a bit of a stretch, but last night as I was kneading my pasta dough and thinking about what I would write in this blog, it came to me that in order to make really good pasta, you need the right tools. You can make pasta without any tools or use a rolling pin, and it will be okay pasta, but if you have one of those windy pasta rollers that get it really thin, and cuts it really evenly for you, it’s sooo much better. It’s the same with FCC – you need the right tools to do a really good job.

Old tools don’t meet clinician needs

According to a survey my colleague David Crowhen and I conducted, the Client Oriented Scale of Improvement (COSI) is the most used communication assessment tool amongst HCPs. It’s not surprising, it’s simple to use and allows us to measure outcomes. But, while it is client oriented, it isn’t designed for teasing out family input.

According to our survey, current commonly used scales do not meet all the needs of the clinician (and therefore the family). Our survey indicated that clinicians want more from their tools. They want a way to include the family, a way to better integrate conversations about technology and finally, they want it available in languages other than English.

FOCAS looks beyond hearing aids

That’s why the Family Oriented Communication Assessment and Solutions (FOCAS) tool was developed. FOCAS addresses the needs of families by providing a clear structure to involve them and it looks beyond hearing aids alone to meet those needs. It is based on the work of great minds – Harvey Dillon (COSI), and Jill Preminger & Christopher Lind from the Goal Sharing for Partners Strategy (GPS).

The FOCAS uses the basic principles of the COSI and the GPS to better involve the family by encouraging the inclusion of both individual and shared goals to assess outcomes. In addition, clinicians are encouraged to focus on the emotional impact and quality of life issues that hearing loss may be causing in the family. A noise versus distance graph allows the clinician to plot the family’s identified needs to facilitate these discussions. To overcome the language barrier causing some clinicians to use no tool at all, the FOCAS has been translated into 22 languages, making it a truly universal tool. So wherever your clinic may be – there is a FOCAS for you.

The FOCAS also offers the clinician a platform to discuss possible technology options in a simple, yet effective way. A small pilot study with 6 clinicians using the FOCAS over the course of 2 months indicated that the ‘technology talk’ was judged to be much easier and swifter, and uptake of recommendations was higher than those of a matched control group.

Truly a FCC tool

Clinicians also reported that where they had thought they had been including the family previously, the FOCAS made it much easier to really explore the family’s point of view and actively involve them in the audiologic process.

Just like the proverbial pasta (or noodle dish) that brings families together weekly in just about every country, having the right tools – like FOCAS – at hand is paramount for bringing families together in your clinic.


Please keep an eye out for a related article in an upcoming Hearing Review publication and visit our Family-Centered Care pages on Phonakpro.com.