Improving Prenatal Palliative Care Consultation Using Diagnostic Trigger Criteria

Authors

• Matthew Lin, Division of Neonatology (M.L.), Department of Pediatrics, New York University School of Medicine, New York, New York, USA. Electronic address: matthew.lin@nyulangone.org.
• Erin Rholl, Division of Neonatology (E.R.), Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
• Nickie Andescavage, Division of Neonatology (N.A.), Children's National Hospital, Washington, District of Columbia, USA; School of Medicine and Health Sciences (N.A., D.F., A.F.L., L.A.M.), George Washington University, Washington, District of Columbia, USA.
• Olivia Ackerman, Prenatal Pediatrics Institute (O.A.), Children's National Hospital, Washington, District of Columbia, USA.
• Deborah Fisher, School of Medicine and Health Sciences (N.A., D.F., A.F.L., L.A.M.), George Washington University, Washington, District of Columbia, USA; Pediatric Palliative Care Program (D.F., A.F.L., L.A.M.), Children's National Hospital, Washington, District of Columbia, USA.
• Ashley F. Lanzel, School of Medicine and Health Sciences (N.A., D.F., A.F.L., L.A.M.), George Washington University, Washington, District of Columbia, USA; Pediatric Palliative Care Program (D.F., A.F.L., L.A.M.), Children's National Hospital, Washington, District of Columbia, USA.
• Laila A. Mahmood, School of Medicine and Health Sciences (N.A., D.F., A.F.L., L.A.M.), George Washington University, Washington, District of Columbia, USA; Pediatric Palliative Care Program (D.F., A.F.L., L.A.M.), Children's National Hospital, Washington, District of Columbia, USA.

Document Type

Journal Article

Publication Date

10-18-2023

Journal

Journal of pain and symptom management

DOI

10.1016/j.jpainsymman.2023.10.015

Keywords

NICU; Quality Improvement; pediatric palliative care; perinatal palliative care

Abstract

BACKGROUND: Three percent of pregnancies are complicated by congenital anomalies. Prenatal integration of pediatric palliative care (PPC) may be hindered by non-standardized PPC referral processes. This quality improvement (QI) project aimed to improve prenatal PPC consultation using a diagnostic trigger list. MEASURES: Main outcome measure was the percentage of prenatal PPC consults completed based on diagnostic trigger list eligibility. Balancing measures included stakeholder perspectives on PPC consults and products. INTERVENTION: Interventions included creation and implementation of a diagnostic trigger list for prenatal PPC consultation, educational initiatives with stakeholders, and iterative modifications of our prenatal consultation process. OUTCOMES: Interventions increased consultation rates ≥80% during the first six months of QI implementation (baseline vs. post-interventions) although this increase was not consistently sustained over a 12-month period. CONCLUSIONS/LESSONS LEARNED: Diagnostic trigger lists improve initial rates of prenatal PPC consultation and additional interventions are likely needed to sustain this increase.

APA Citation

Lin, Matthew; Rholl, Erin; Andescavage, Nickie; Ackerman, Olivia; Fisher, Deborah; Lanzel, Ashley F.; and Mahmood, Laila A., "Improving Prenatal Palliative Care Consultation Using Diagnostic Trigger Criteria" (2023). GW Authored Works. Paper 3576.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3576

Department

Medicine