Serious Illness Conversations in Pediatrics: A Case Review

Area of Science:

• Pediatric Palliative Care
• Health Communication
• Clinical Decision-Making

Background:

• Ariadne Labs developed the Serious Illness Conversation Guide for adult patients.
• Pediatric palliative care clinicians adapted the guide for parents of children with serious illnesses, creating the SICG-Peds.

Observation:

• The SICG-Peds, combined with enhanced communication skills, helps clarify parental understanding of a child's illness and their values.
• The guide facilitates goal-based, efficient, comprehensive, and consistent communication between families and clinicians.

Findings:

• The SICG-Peds systematically guides clinicians through crucial conversations.
• Key steps include seeking permission, assessing understanding, sharing prognosis, and exploring topics like hopes, fears, strengths, and trade-offs.
• The process concludes with formulating clinician recommendations.

Implications:

• Expanding the use of SICG-Peds ensures seriously ill children receive care tailored to their needs throughout their disease trajectory.
• This tool promotes patient-centered care and shared decision-making in pediatric palliative care.
• The SICG-Peds can enhance the quality of communication and care planning for children with serious illnesses.