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Interdisciplinary interventions to improve pediatric palliative care and reduce health care professional suffering
Cynda Hylton Rushton1, Elizabeth Reder, Barbara Hall
1School of Nursing, The Johns Hopkins University, Baltimore, Maryland 21287, USA. crushton@son.jhmi.edu
Insights
A quality improvement program successfully educated and supported healthcare professionals in pediatric palliative care. The interdisciplinary approach enhanced competence and confidence in managing grief when caring for children with life-threatening conditions.
Area of Science:
- Pediatric Palliative Care
- Healthcare Professional Education
- Quality Improvement
Background:
- Healthcare professionals caring for dying children require specialized education and support.
- Managing personal grief is a critical aspect of pediatric end-of-life care.
- Existing educational frameworks may not adequately address the unique needs of this population.
Purpose of the Study:
- To implement and evaluate a quality improvement program focused on interdisciplinary palliative care education.
- To enhance the competence, confidence, and grief management skills of healthcare professionals.
- To support clinicians providing end-of-life care to children with life-threatening conditions.
Main Methods:
- A quality improvement program involving four interdisciplinary activities was implemented.
- Activities included the Compassionate Care Network (CCN), Palliative Care Rounds (PCR), Patient Care Conferences (PCC), and Bereavement Debriefing Sessions (BDS).
- Data collected included session frequency, participant numbers and disciplines, patient demographics, and participant evaluations.
Main Results:
- 101 sessions were conducted, engaging 950 participants across various disciplines.
- All hospital units and professional disciplines participated in the program.
- Participant evaluations indicated that the sessions were informative and influenced professional practice.
Conclusions:
- Interdisciplinary interventions effectively educate and support healthcare professionals in pediatric palliative and end-of-life care.
- The program model demonstrated success in enhancing clinician skills and confidence.
- This program can be adapted for implementation in various pediatric healthcare settings.
Objective:
To implement and evaluate a quality improvement program of interdisciplinary palliative care education and support intended to increase the competence, confidence and ability to manage personal grief of health care professionals caring for dying children.
Setting:
A children's hospital in an urban academic medical center.
Participants:
Pediatric health care professionals of all disciplines caring for children with life-threatening conditions.
Interventions:
We initiated a quality improvement program of professional education and support consisting of four interdisciplinary activities facilitated by the pediatric palliative care team. The Compassionate Care Network (CCN) provides an open forum for interdisciplinary networking and education. Palliative Care Rounds (PCR) provides education through monthly case-based discussions on selected units. Patient Care Conferences (PCC) facilitate communication and care planning for selected patients with palliative care needs on any unit in the children's center. Bereavement Debriefing Sessions (BDS) offer health professionals the opportunity to manage their responses to grief after a patient's death. EVALUATION MEASURES: From February 2002 to September 2003, we prospectively tracked the frequency of sessions conducted, the number and discipline of attendees, the age and diagnosis of patients discussed, and themes raised at each session. Participants evaluated each session.
Results:
One hundred one sessions were conducted (PCR = 31, PCC = 23, CCN = 9, BDS = 38) for 950 participants (PCR = 312, PCC = 188, CCN = 193, BDS = 257). All units and disciplines participated in one or more sessions. Evaluations report that sessions are informative and will influence future professional practice.
Conclusions:
A program of interdisciplinary interventions can successfully educate and support health care professionals in providing palliative and end-of-life care for children. This program model can be applied in diverse pediatric health care settings.
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