The Chameleon Project: A children's end of life care quality improvement project

Title

The Chameleon Project: A children's end of life care quality improvement project

Creator

Wolff A; Dorsett C; Haynes S; Whitehouse W P; Clements H; Griffin H; Chhaochharia A; Connolly A; Kelly N; Turnbull J; Deorukker S; Hill S; Batey N; Douglas E; Sheikh N; Bifani E; Lovegrove S; Webb K; Manning J

Identifier

Publisher

Developmental Medicine and Child Neurology

Date

2020

Subject

Chameleon Project; children; end-of-life; quality improvement project

Description

Objective: NHS England's Marginal Rate Emergency Threshold (MRET) and Readmission Fund funded the Chameleon Project 2018 (Twitter account: @chameleonproje1), to improve children's end of life care. This funded a lead disability paediatrician with expertise in Paediatric Palliative Care (10h/wk), a children's palliative care nurse (3d/wk) a network administrator (2d/wk), and additional hours for paediatricians in the critical care, oncology, and neonatal units, and in each of the local district general hospitals (total 18h/wk). Method(s): Tools were developed to aid identification of children in the last year of life and to support anticipatory care planning. The team attended ward rounds and provided teaching sessions, advice and support. Children who died an expected death in the 12 months of the project were ascertained from the child death review teams. Non-elective admissions, bed days, and costs were tabulated. We also evaluated the documentation of care plans and post bereavement family feedback questionnaires. Result(s): 29 children died an expected death. The same number died during the previous 12 months. The median number of non-elective admissions reduced from 2 to 1 per child, specialist ward bed days reduced from 504 to 251 (50% reduction). For children admitted to PICU in the last 12 months of life, the total PICU bed days reduced from 342 to 184 (46% reduction), the median length of stay reduced from 21 days to 11 days, and the maximum length of stay reduced from 141 days to 38 days. The percentage of children who died an expected death who had documented anticipatory care plans rose from 50% to 72%. Conclusion(s): The network of clinicians with expertise in paediatric palliative care working together across a region improved anticipatory care planning and reduced admissions and bed days for children in their last year of life: better care with reduced costs.

Rights

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).

Citation List Month

July 2020 List

Collection

Citation

Wolff A; Dorsett C; Haynes S; Whitehouse W P; Clements H; Griffin H; Chhaochharia A; Connolly A; Kelly N; Turnbull J; Deorukker S; Hill S; Batey N; Douglas E; Sheikh N; Bifani E; Lovegrove S; Webb K; Manning J, “The Chameleon Project: A children's end of life care quality improvement project,” Pediatric Palliative Care Library, accessed July 26, 2021, https://pedpalascnetlibrary.omeka.net/items/show/17156.

Social Bookmarking