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Published on: January 12, 2018
Outcomes following perinatal palliative care consultation: a retrospective review
Megan H Tucker1, Kelstan Ellis2, Jennifer Linebarger2
1Department of Neonatology, Children's Mercy Kansas City, University of Missouri-Kansas City, Kansas City, MO, USA. meganlanehudson@gmail.com.
Insights
Perinatal palliative care teams (PaCT) offer vital support within fetal health centers (FHCs). This model demonstrates increasing integration and value in improving care for high-risk infants and families.
Area of Science:
- Perinatal Medicine
- Palliative Care
- Healthcare Delivery Models
Background:
- Fetal health centers (FHCs) manage complex pregnancies.
- Integrating palliative care into FHCs is crucial for comprehensive infant and family support.
- A structured model is needed to guide perinatal palliative care team (PaCT) services within FHCs.
Purpose of the Study:
- To describe a model for delivering perinatal palliative care within a dedicated fetal health center.
- To evaluate the integration and impact of a palliative care team (PaCT) in a freestanding children's hospital FHC.
Main Methods:
- Retrospective review of the PaCT database within the FHC from 2010 to 2018.
- Survey of FHC neonatologists to assess the perceived value of the PaCT.
Main Results:
- PaCT consultations within the FHC increased significantly from 1 in 2010 to 102 in 2018.
- PaCT engaged with 430 mothers prenatally, providing care for 390 live-born infants.
- Outcomes included 172 infant deaths, 48 receiving comfort care, and 19 surviving to discharge with hospice.
Conclusions:
- The palliative care team (PaCT) is an integral service within the FHC.
- Increasing consultation volume and perceived value by neonatologists support the model's effectiveness.
- The described model successfully integrates perinatal palliative care into a high-level fetal health center.
Objective:
To inform clinical practice by describing a model of perinatal palliative care delivery within a fully staffed fetal health center (FHC) inside a freestanding children's hospital.
Study Design:
The team conducted a retrospective chart review of the palliative care team (PaCT) database from FHC's inception in 2010 to 31 December, 2018, and surveyed the FHC neonatologists.
Results:
PaCT consults in the FHC increased from 1 in 2010 to 102 in 2018. PaCT met 430 mothers for prenatal consultation. Of the 390 live-born infants, 172 died; 48 received comfort care only from birth; and 19 survived to discharge home with hospice. At the time of review, PaCT still follows 109 children met prenatally. PaCT discharged 96 patients that no longer required PaCT services.
Conclusions:
PaCT provides an integral service within the FHC as evidenced by the increasing volume of consultations, variety of care provided and perceived value by FHC neonatologists.
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