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Published on: February 19, 2021
Implementing the PAR Scale in a Pediatric Concurrent Care Setting: A Quality Improvement Project.
Taylor Ronne1, Andrea Cahill2, Kassidy Horst3
1Taylor Ronne, BSN, RN is Doctoral Student, University of Nebraska Medical Center, Omaha, NE.
Summary
Implementing a new tool for pediatric hospice care did not significantly improve communication about family goals. Sustained education and team engagement are crucial for aligning treatment with patient preferences.
Area of Science:
- Pediatric Palliative Care
- Quality Improvement
- Healthcare Communication
Background:
- Fragmented communication regarding family goals of care is common for pediatric patients in concurrent hospice and palliative care during hospitalizations.
- Ensuring treatment aligns with family preferences is vital in complex pediatric settings.
Purpose of the Study:
- To evaluate clinician and care coordinator experiences with implementing the Preference for Acute Rehospitalization Scale.
- To assess the impact of a new communication tool on awareness of family goals and decision-making confidence.
Main Methods:
- A quality improvement project utilized a pre- and postimplementation survey design.
- Surveys assessed interdisciplinary team members' awareness of family goals, decision-making confidence, and perceptions of the tool.
- Participants included clinicians and care coordinators at Children's Nebraska.
Main Results:
- Clinicians showed general openness to standardized communication tools.
- No statistically significant differences were found in survey items assessing awareness, confidence, or perceptions postimplementation.
- The study highlighted challenges in tool adoption within complex pediatric care.
Conclusions:
- Successful adoption of communication tools in pediatric hospice and palliative care requires more than initial implementation.
- Sustained education, seamless workflow integration, and robust interdisciplinary engagement are necessary.
- These factors are critical for ensuring treatment remains aligned with family preferences.
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