Pediatric Home-Based Hospice and Palliative Medicine Provider Home Visits: A Multisite Study

Title

Pediatric Home-Based Hospice and Palliative Medicine Provider Home Visits: A Multisite Study

Creator

Cicozi K; Smith SM; Grossoehme DH; Hiltunen A; Roth C; Richner G; Kim SS; Friebert S

Publisher

Journal of Palliative Medicine

Date

2023

Subject

home visit; home-based palliative care and hospice; Hospice; Palliative Care; pediatric palliative care

Description

Background: Pediatric home-based palliative care and/or hospice provider (Physician, Advanced Practice Nurse, or Physician Assistant) home visits are an underexplored subject in the literature with little available descriptive data and limited evidence guiding how best to utilize them. Objectives: Describe the population receiving hospice and palliative medicine (HPM) provider home visits and characterize visit themes. Design: Retrospective chart review of electronic medical record (EMR) data Setting/Subjects: A total of 226 individuals 1 month to 21 years of age, who received an HPM provider home visit from January 1, 2013, to December 31, 2018; two large quaternary medical centers in the Midwest. Measurements: Demographic data, content, and details from home visit abstracted from the EMR. Results: The three most common diagnostic groups receiving HPM provider home visits were neurological (42%), congenital chromosomal (26%), and prematurity-related (14%) conditions. Goals of care (GOC) were discussed at 29% of visits; most commonly, goals related to code status (42%), technology dependence (20%), and nutrition/hydration (15%). A change in GOC occurred in 44% of visits. Forms of anticipatory guidance addressed were nutrition (68%), side effects of treatment (63%), pain assessment (59%), decline/death (32%), and allow natural death/do not resuscitate/advance directives (26%). Conclusion: HPM provider visits are diverse in content and changes in plan of care with potential for proactive identification of GOC and provision of important anticipatory guidance around patient decline and end of life. Further research is indicated to establish which populations benefit most and how to leverage this scarce resource strategically.

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

March List 2023

Collection

Citation

Cicozi K; Smith SM; Grossoehme DH; Hiltunen A; Roth C; Richner G; Kim SS; Friebert S, “Pediatric Home-Based Hospice and Palliative Medicine Provider Home Visits: A Multisite Study,” Pediatric Palliative Care Library, accessed May 30, 2024, https://pedpalascnetlibrary.omeka.net/items/show/18669.