Pediatric Chronic Critical Illness: Training teams to address the communication challenges of patients with repeated and prolonged hospitalizations

Title

Pediatric Chronic Critical Illness: Training teams to address the communication challenges of patients with repeated and prolonged hospitalizations

Creator

Boss R D; Hirschfeld R S; Silvana B; Emily J; Arnold R M

Publisher

Journal of Pain and Symptom Management

Date

2020

Subject

Chronic critical illness; Communication; medical education

Description

CONTEXT: Children with chronic critical illness (CCI) have repeated and prolonged hospitalizations. Discrete communication challenges characterize their inpatient care. OBJECTIVES: Develop, implement and evaluate a communication training for inpatient clinicians managing pediatric CCI. METHODS: A one-day communication training for interdisciplinary clinicians, incorporating didactic sessions and simulated family and interdisciplinary team meetings. RESULTS: Learners had an average of 11 years' clinical experience. 34% lacked prior communication training relevant to pediatric CCI. Mean baseline competence across communication skills was 2.6 (range 2.4-3.2), corresponding to less than "somewhat prepared"; after the training this increased to a mean of 4.0 (range 3.5-4.5), corresponding to "well prepared." Skills with greatest improvement included conducting a family meeting, delivering bad news, discussing stopping intensive care, and end of life communication. After 1 month, perceived competence was sustained for 7/10 skills; for remaining skills, perceived competence scores decreased by 0.1-0.2. 100% of learners would recommend the training to colleagues; 89% advocated it for all clinicians caring for children with CCI. CONCLUSION: Interdisciplinary communication training regarding long stay patients is feasible and valued by novice and seasoned clinicians. The novel integration of intra-team communication skills alongside team-family skills reflects the reality that the care of children with CCI challenges clinicians to communicate well with each other and with families. Teaching interdisciplinary teams to share communication skills has the potential to overcome reported limitations of existing inpatient discussions, which can be dominated by one or two physicians and lack contributions from diverse team members.

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

August 2020 List

Collection

Citation

Boss R D; Hirschfeld R S; Silvana B; Emily J; Arnold R M, “Pediatric Chronic Critical Illness: Training teams to address the communication challenges of patients with repeated and prolonged hospitalizations,” Pediatric Palliative Care Library, accessed December 8, 2021, https://pedpalascnetlibrary.omeka.net/items/show/17162.

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