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IPPC is actively seeking to collaborate with children's hospitals,
pediatric units within general hospitals, and hospice or home care
settings serving children and families. Beginning in the fall of
2004, a series of regional educational retreats for interdisciplinary
teams will be held in which participants will be exposed to the
IPPC curriculum and helped to develop the skills and strategies
for implementing the curriculum in their home institutions. If your
team or institution is interested in receiving more information
about these educational opportunities as details become available,
please contact IPPC project coordinator, Jean Doherty at jdoherty@edc.org.
Several leading hospitals have collaborated with IPPC to develop and implement
exemplary quality improvement projects and to pilot test the IPPC
curriculum. These are:
For more information about the IPPC-related activities initiated at these hospitals, please see below.
Children's Hospital of Boston/Dana Farber Cancer Institute
Contact:
Joanne Wolfe, MD, MPH
Medical Director, Pediatric Advanced Care Team
Children's Hospital of Boston/Dana-Farber Cancer Institute
Dane 3
44 Binney Street
Boston, MA 02115
Phone: 617-632-5286
Email: joanne_wolfe@dfci.harvard.edu
Janet M. Duncan, MSN, RN
Clinical Educator, Pediatric Advanced Care Team
Children's Boston Hospital of Boston and Dana-Farber Cancer Institute
7 West
300 Longwood Avenue
Boston, MA 02115
Phone: 617-355-5231
Email: janet.duncan@tch.harvard.edu
Quality Improvement Initiative:
The Pediatric Advanced Care Team is a palliative care service for
children with advanced illnesses at Children's Hospital of Boston
and the Dana-Farber Cancer Institute. Established in 1997, this
service is one of the first of its kind in the United States. The
primary goal of our IPPC project is to increase utilization of the
Pediatric Advanced Care Team (PACT) in three target services: neurology,
pulmonology and the CCS (Coordinated Care Service—for children
with genetic disorders and complex medical problems). Key "change
agents" from selected services have been invited to become active
members of the PACT. Prospective data collection to assess impact
will include: attendance at monthly PACT educational meetings, number
of consults from target services, and needs of patients, families
and consult team. We anticipate the key success factor will be the
degree of endorsement by medical, nursing and social work leadership.
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Children's Hospital of Philadelphia
Contact:
Tammy Kang, MD
Medical Director
Pediatric Advanced Care Team
Clinical Instructor
Division of Oncology
The Children's Hospital of Philadelphia
4304 Wood Building
34th and Civic Center Blvd
Phildelphia, PA 19104
Phone: 267-426-5051
Email: KANG@email.chop.edu
Quality Improvement Initiative:
Patients between the ages of 5 and 18 who are receiving bone marrow transplants are eligible for participation in this quality improvement initiative. A specially trained and certified art therapist provides six art therapy sessions to support the patient's involvement in his or her own illness experience and to foster verbal and non-verbal communication with and among the patient, the family, and the healthcare team. Concurrently, the patient, primary family caretaker, and members of the healthcare team are surveyed to measure, (1) the participant's understanding of the patient's diagnosis, current condition, and treatment outcomes, (2) the participant's beliefs regarding frequency of communication about the patient's diagnosis, condition, and treatment outcomes, (3) the participant's comfort level with the discussions about the patient's diagnosis, condition and treatment outcomes, and (4) the extent to which art therapy has changed the participant's frequency and comfort in communication about the patient's diagnosis, condition, and treatment outcomes.
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Children's Mercy Hospitals and Clinics
Contact:
Jill Burris Linn, MDiv
Staff Chaplain and Program Director
Pediatric Advanced Comfort Care Team (PACCT) Chaplaincy
The Children's Mercy Hospital
2401 Gillham Road
Kansas City, MO 64108
Phone: 816-234-3000 x7803
Email: jlinn@cmh.edu
Quality Improvement Initiative:
The focus of our IPPC project is the implementation of a clinical
pathway being developed by the Pediatric Advanced Comfort Care Team
(PACCT) for the Gastroenterology (GI) Section. The pathway will
direct the care of complex and terminally ill patients from diagnosis
to cure or death. The pathway will be a tool to provide consistent
holistic care, both medical and psychological, and to improve communication
among patients and staff.
Pathway effectiveness will be measured by patient and family satisfaction, staff satisfaction, tracking the number of consultations by the PACCT from the GI section, measuring lengths of stay in the hospital and intensive care, and tracking the team meeting content. In addition a values inventory will be used to assess parental beliefs at program enrollment and again after completion of the education component of the intervention.
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Johns Hopkins Children's Center
Contact:
Cynda H. Rushton, DNSc, RN, FAAN
Harriet Lane Compassionate Care Coordinator
Johns Hopkins Children's Center
2312 Henslowe Drive
Potomac, MD 20854
Phone: 410-614-2223
Email: crushton@son.jhmi.edu
Quality Improvement Initiative:
The goal of the IPPC project at Johns Hopkins Children's Center
is to promote excellence in pediatric palliative care provided to
patients and families by focusing on the staff providing the care.
The premise of Harriet Lane Compassionate Care—an interdisciplinary
palliative care team—is that if we can reduce the suffering
of caregivers who care for children with life-threatening conditions,
and strengthen their ability to accommodate grief, they will be
better able to provide care for children and families. We have developed
a comprehensive system of support for health care professionals,
including providing information about pediatric palliative care,
clinical support for the interdisciplinary team, emotional support
and opportunities to make meaning in the face of suffering, death
and grief. We believe the staff and, in turn, the patients and families,
will benefit greatly from this unique approach to enhancing family-centered
care.
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University of California, San Francisco Children's Hospital
Contact:
Robin Kramer, RN, MS, PNP
Clinical Nurse Specialist
Pediatric Oncology
UCSF Children's Hospital
Box 0106
University of California, San Francisco
San Francisco, CA 94143
Phone: 415 353-2770
Email: robin.kramer@ucsfmedctr.org
Quality Improvement Initiative:
Our overall goal is to develop a pediatric palliative care program
at UCSF Children's Hospital. The cornerstones of the program will
be shaped by a comprehensive needs assessment, which includes a
medical record audit of pediatric hospital deaths and surveys of
both staff and parents to better understand their perceptions of
end-of-life care provided in the hospital setting. These data will
help us identify strengths and weaknesses in care, allowing us to
target priority areas for improving the overall quality of care.
Our palliative care initiative also includes the development of
12 hours of core content, which is being used for interdisciplinary
staff training.
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Vanderbilt University Children's Hospital
Contact:
Brian S. Carter, MD, FAAP
Professor of Pediatrics
Monroe Carell, Jr. Children's Hospital at Vanderbilt
11111 Doctor's Office Way
2200 Children's Way
Nashville, TN 37232-9544
Phone: (615) 322-3476
Email: Brian.Carter@mcmail.vanderbilt.edu
Quality Improvement Initiative:
Our local IPPC project, Pediatric Pain and Symptom Management—A
First Step Toward Pediatric Palliative Care at Vanderbilt Children's
Hospital, has three goals. The first is to examine the number of
children who die at Vanderbilt Children's Hospital after being hospitalized
for more than 24 hours in the NICU, PICU, Oncology Service, and
Cardiology Service, and describe the circumstances and conditions
around their death for the patient, family, and staff as they pertain
to patient pain and other symptoms at the end of life. The second
is to improve practitioners' understanding and attention to the
circumstances around child death at Vanderbilt, especially as it
pertains to patient pain and symptom assessment and management.
The third goal is to develop a continuous quality improvement tool
to ascertain and track or monitor, in a prospective sense, how pain
and symptom assessment and management are addressed at the end of
life for children.
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Lucile Packard Children's Hospital at Stanford University
Contact:
Barbara M. Sourkes, PhD
Kriewall-Haehl Director
Pediatric Palliative Care Program
Lucile Packard Children's Hospital at Stanford University
725 Welch Road, Room 2129
Palo Alto, CA 94304
Phone: 650-497-8963
Email: bsourkes@stanford.edu
Pilot Activities:
The Lucile Packard Children's Hospital at Stanford University
joined the initiative to serve as an additional field-test
site for the IPPC curriculum materials.
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