Clare O Riotte1, Stephanie K Kukora2,3, Patricia M Keefer4, Janice I Firn3,5. 1. 1 Pain and Palliative Medicine, Connecticut Children's Medical Center , Hartford, Connecticut. 2. 2 Division of Neonatal-Perinatal Medicine, C.S. Mott Children's Hospital and Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan. 3. 3 Center for Bioethics and Social Sciences in Medicine , Michigan Medicine, Ann Arbor, Michigan. 4. 4 Pediatric Palliative Care Program, C.S. Mott Children's Hospital and Department of Pediatrics, Michigan Medicine, Ann Arbor, Michigan. 5. 5 Division of Geriatric and Palliative Medicine, Department of Internal Medicine , Michigan Medicine, Ann Arbor, Michigan.
Abstract
BACKGROUND: Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. OBJECTIVE: We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. DESIGN: Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. SETTING/ SUBJECTS: Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. MEASUREMENTS: Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. RESULTS: Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. CONCLUSIONS: Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.
BACKGROUND: Despite the number of interprofessional team members caring for children at the end of life, little evidence exists on how institutions can support their staff in providing care in these situations. OBJECTIVE: We sought to evaluate which aspects of the hospital work environment were most helpful for multidisciplinary team members who care for patients at the end of life and identify areas for improvement to better address staff needs. DESIGN: Qualitative thematic analysis was completed of free-text comments from a survey distributed to interprofessional staff members involved in the care of a recently deceased pediatric patient. A total of 2701 surveys were sent; 890 completed. Free-text responses were provided by 306 interprofessional team members. SETTING/ SUBJECTS: Interprofessional team members involved in the care of a child who died at a 348 bed academic children's hospital in the Midwestern United States. MEASUREMENTS: Realist thematic analysis of free-text responses was completed in Dedoose using a deductive and inductive approach with line-by-line coding. Descriptive statistics of demographic information was completed using Excel. RESULTS: Thematic analysis of the 306 free-text responses identified three main support-related themes. Interprofessional team members desire to have (1) support through educational efforts such as workshops, (2) support from colleagues, and (3) support through institutional practices. CONCLUSIONS: Providers who participate in end-of-life work benefit from ongoing support through education, interpersonal relationships, and institutional practices. Addressing these areas from an interprofessional perspective enables staff to provide the optimal care for patients, patients' families, and themselves.
Entities:
Keywords:
coping; interprofessional teams; pediatric death; provider support needs
Authors: Valerie Bailey; Dorothy M Beke; Jennifer M Snaman; Faraz Alizadeh; Sarah Goldberg; Melissa Smith-Parrish; Kimberlee Gauvreau; Elizabeth D Blume; Katie M Moynihan Journal: JAMA Netw Open Date: 2022-05-02