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40
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Dublin Core
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Title
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August 2021 List
Text
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August 2021 List
URL Address
<a href="http://doi.org/10.1177/10499091211026675" target="_blank" rel="noreferrer noopener">http://doi.org/10.1177/10499091211026675</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Evaluation of a Quality Improvement Intervention to Improve Pediatric Palliative Care Consultation Processes
Publisher
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American Journal of Hospital and Palliative Care
Date
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2021
Subject
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psychosocial; pediatrics; palliative care; Covid-19; interdisciplinary; quality improvement; Pdsa; quality measures
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Stoyell JF; Jordan M; Derouin A; Thompson J; Gall S; Jooste KR; Keskinyan VS; Lakis KR; Lee YA; Docherty S
Description
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BACKGROUND: A critical aspect of pediatric palliative care consultations is the assessment and documentation of patient and family needs. While these assessments usually include a focus on physical pain, there is less standardization of assessments of other physical symptoms and psychosocial, emotional, or spiritual needs. AIMS: To improve the breadth of assessment of psychosocial and emotional needs, screen for symptoms other than pain among pediatric patients utilizing palliative care services, and to increase documentation of assessment data from 30%-40% to 80% through practice changes implemented in 2 Plan-Do-Study-Act (PDSA) cycles. METHODS: This quality improvement project involved implementing provider education and adapting the palliative care consultation template in the electronic health record to improve breadth and consistency of assessment and documentation during consultations by the interdisciplinary pediatric palliative care team. Two PDSA cycles were performed. Chi squared tests and statistical control charts were used for data analysis. RESULTS: There was statistically significant improvement in the inclusion of documentation of a pediatric palliative care social work note from baseline (32%) to Cycle 2 (57%). Physical symptom screening declined slightly, but not significantly (p = .32) and socio-emotional discussions also declined but not significantly (p = .05). CONCLUSIONS: Screening for physical symptoms and discussions with patients and families about psychosocial/emotional needs during the initial palliative care consultations are extremely important in providing effective, holistic, patient-centered care. There is a need for development of pediatric-centric guidelines and quality measures to evaluate pediatric palliative care programs; further research is indicated to determine methods for evaluating compliance with these guidelines.
Identifier
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<a href="http://doi.org/10.1177/10499091211026675" target="_blank" rel="noreferrer noopener">10.1177/10499091211026675</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2021
American Journal of Hospital and Palliative Care
August 2021 List
COVID-19
Derouin A
Docherty S
Gall S
Interdisciplinary
Jooste KR
Jordan M
Keskinyan VS
Lakis KR
Lee YA
Palliative Care
PDSA
Pediatrics
psychosocial
Quality Improvement
quality measures
Stoyell JF
Thompson J
-
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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May 2023 List
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
May List 2023
URL Address
<a href="http://doi.org/10.1016/j.jpeds.2022.10.003" target="_blank" rel="noreferrer noopener"> http://doi.org/10.1016/j.jpeds.2022.10.003</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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Goal-Concordance in Children with Complex Chronic Conditions
Publisher
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The Journal of Pediatrics
Date
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2023
Subject
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Hospice Care; Terminal Care; Child; Chronic Disease; Goals; Humans; Only Child; Resuscitation Orders
Creator
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Harmon A; Jordan M; Platt A; Wilson J; Keith K; Chandrashekaran S; Schlichte L; Pendergast J; Ming D
Description
An account of the resource
Abstract Objectives: To characterize delivery of goal-concordant end-of-life (EOL) care among children with complex chronic conditions and to determine factors associated with goal-concordance. Study design: This was a retrospective review of goals of care discussions for 272 children with at least 1 complex chronic condition who died at a tertiary care hospital between January 1, 2014, and December 31, 2017. Goals of care and code status were assessed before and within the last 72 hours of life. Goals of care discussions were coded as full interventions; considering withdrawal of interventions (palliation); planned transition to palliation; or actively transitioning/transitioned to palliation. Results: In total, 158 children had documented goals of care discussions before and within the last 72 hours of life, 18 had goals of care discussions only >72 hours before death, 54 only in the last 72 hours of life, and 42 had no documented goals of care. For children with goals of care, EOL care was goal-concordant for 82.2%, discordant in 7%, and unclear in 10.8%. Black children had a greater than 8-fold greater odds of discordant care compared with White children (OR 8.34, P = .007). Comparison of goals of care and code status before and within the last 72 hours of life revealed trends toward nonescalation of care. Specifically, rates of active palliation increased from 11.7% to 63.0%, and code status shifted from 32.6% do not resuscitate to 65.2% (P < .001). Conclusions: In this cohort, a majority of children had documented goals of care discussions and received goal-concordant EOL care. However, Black children had greater odds of receiving goal-discordant care. Goals of care and code status shifted toward palliation during the last 72 hours of life.
Identifier
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<a href="http://doi.org/10.1016/j.jpeds.2022.10.003" target="_blank" rel="noreferrer noopener">10.1016/j.jpeds.2022.10.003</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2023
Chandrashekaran S
Child
Chronic Disease
Goals
Harmon A
Hospice Care
Humans
Jordan M
Keith K
May List 2023
Ming D
Only Child
Pendergast J
Platt A
Resuscitation Orders
Schlichte L
Terminal Care
The Journal Of Pediatrics
Wilson J