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Palliative Care in the Pediatric Emergency Department: Findings From a Qualitative Study

Anne-Josée Côté1, Antoine Payot2, Nathalie Gaucher3

  • 1Department of Pediatrics, Montreal Children's Hospital, Montreal, Quebec, Canada.

Annals of Emergency Medicine
|May 8, 2019
PubMed

Insights

Pediatric palliative care in the emergency department (ED) faces challenges due to ED culture and lack of care continuity. Addressing these can improve care for children with medical complexity.

Area of Science:

  • Pediatric Palliative Care
  • Emergency Medicine
  • Complex Care

Background:

  • Children with medical complexity are a vulnerable population frequently requiring pediatric palliative care.
  • The role of the emergency department (ED) in caring for these children and their families is not well understood.

Purpose of the Study:

  • To explore healthcare professionals' perspectives on providing pediatric palliative care within the ED setting.

Main Methods:

  • Semistructured focus groups were conducted with healthcare professionals from pediatric emergency medicine, palliative care, complex care, and intensive care.
  • Data were transcribed and analyzed using thematic analysis and theoretic sampling.

Main Results:

  • Barriers to pediatric palliative care in the ED include its unique culture, emotional responses of staff, and lack of care continuity.
  • Recommendations for ED professionals include evaluating clinical situations, contacting existing care teams, respecting family preferences, managing symptoms, and fostering a supportive environment.
  • Improved inter-team communication is crucial for patient flow and care quality.

Conclusions:

  • Despite differing perspectives, barriers to high-quality emergency pediatric palliative care can be overcome.
  • Enhancing care requires addressing ED-specific challenges and improving coordination with external healthcare teams.
Abstract

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