Increasing joy for pediatric palliative care providers: #pactimpact a quality improvement initiative for resiliency in the workplace


Increasing joy for pediatric palliative care providers: #pactimpact a quality improvement initiative for resiliency in the workplace


Morvant A; Jones E






child; coffee; conference abstract; controlled study; home visit; human; outcome assessment; palliative therapy; patient care; self report; total quality management; Workplace


Our pediatric palliative care group is called the "Pediatric Advanced Care Team," also known as "PACT." We created a novel system called #PACTimpact to identify situations in which team members go above and beyond for patients providing meaningful impact for our families. We hypothesize that by recognizing the impact we make on families we will bring more joy in the workplace ultimately facilitating improved resiliency. These impacts may be big or small such as conducting an afterhours home visit or bringing a parent a coffee. Problem statement: Pediatric palliative care (PPC) is emotionally difficult and we are at risk for suboptimal resiliency. PPC clinicians may not recognize the full value they provide. Currently, we do not have a system in place for improving joy or resiliency. AIM: By April 2018, we will improve our "joy meter" in our PACT members from our baseline of 53% to 75%. Process for improvement: Utilizing the model for improvement we asked 3 key questions. What are we trying to accomplish: Increased resiliency and joy. How will we know the change is an improvement: Regular periodic surveys of the "joy meter." What change can we make that will result in improvement: Increase recognition of impactful patient care. During the initial PDSA cycle we encouraged team members to tweet impacts using the hashtag #PACTimpact. Assessment of the initial cycle revealed that many team members were unfamiliar with twitter so a post-it note board was utilized as well. The number of impacts recorded increased as a result of this change. The outcome measure was assessed using a SurveyMonkey to have team members rate joy on a sliding scale before and after the intervention. Process measure: Number of impacts recorded. Totaled weekly. Outcome measure: Average team joy on 0-100 scale. Balance measure: Qualitative report of negative impacts on team members Discussion: Our aim was not achieved. Comments indicated our intervention is effective at improving joy. We are planning additional cycles to attain our aim, which was to increase our "joy meter" from our baseline of 53% to 75%. We increased the "joy meter" to 69% after our first three-week cycle. Factors that affected success: We depended on members to notify us about meaningful impact on patient care. Some #PACTimpacts could be missed if members did not self-report or report other positive impacts on patient care. Next steps: We will continue to use our "joy meter" to track joy in the workplace. We will reach out to other departments to ask them to recognize when we are helpful with patient care to broaden our recognition scope. We will consider appointing a wellness officer, and we will continue to track the "joy meter" through interventions as this position is developed.


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Morvant A; Jones E, “Increasing joy for pediatric palliative care providers: #pactimpact a quality improvement initiative for resiliency in the workplace,” Pediatric Palliative Care Library, accessed October 3, 2023,