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Increasing Pediatric Palliative Care Consultation for Patients with Heart Disease and Prolonged Cardiac Intensive

Andrew Headrick1, Sarah Wawrzynski2, Judson Moore1

  • 1From the Department of Pediatrics, Division of Cardiology, University of Utah at Primary Children's Hospital, Salt Lake City, Utah.

Pediatric Quality & Safety
|February 21, 2025
PubMed

Insights

Quality improvement initiatives significantly increased pediatric palliative care (PPC) consultations for children with heart disease in the cardiac intensive care unit (CICU). These interventions improved care coordination and family support for complex medical cases.

Area of Science:

  • Pediatric Cardiology
  • Palliative Care
  • Quality Improvement Science

Background:

  • Congenital heart disease (CHD) patients are medically complex, facing high morbidity and mortality.
  • Pediatric palliative care (PPC) is crucial for supporting families with complex medical needs.
  • Optimizing PPC integration in cardiac intensive care units (CICUs) is essential for improving patient and family outcomes.

Purpose of the Study:

  • To evaluate the impact of quality improvement (QI) interventions on increasing PPC consultations.
  • To assess the effect of QI on PPC integration for patients with prolonged CICU length of stay (LOS) (≥14 days).
  • To gather perceptions of PPC involvement from CICU team members and patient families.

Main Methods:

  • A mixed-methods QI study was conducted in a CICU.
  • Interventions included digital screening prompts and weekly team huddles for eligible patients (CICU LOS ≥14 days).
  • Data collected via surveys from CICU team members and family members of consulted patients.

Main Results:

  • PPC consultation rates increased significantly from 35% preintervention to 63% postintervention (P < 0.01).
  • Consultation timing remained consistent across study phases.
  • Surveys indicated predominantly positive perceptions of PPC involvement from both families and CICU staff.

Conclusions:

  • QI interventions, specifically digital prompts and collaborative huddles, effectively increased PPC consultations for cardiac patients in the CICU.
  • PPC consultation is perceived positively by families and healthcare teams, enhancing care for complex pediatric heart conditions.
Abstract

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