An Automatic Pediatric Palliative Care Consultation for Children Supported on Extracorporeal Membrane Oxygenation: A Survey of Perceived Benefits and Barriers.
Claudia Delgado-CorcoranSarah E WawrzynskiKelly J MansfieldBrian FlahertyDanielle D DeCourceyDominic MooreLawrence J CookChristina K UllrichLenora M OlsonPublished in: Journal of palliative medicine (2022)
Background: Pediatric palliative care (PPC) consultation is infrequent among children on extracorporeal membrane oxygenation (ECMO). Objective: Investigate intensive care unit (ICU) team members' perceptions of automatic PPC consultation for children on ECMO in an ICU in the United States. Methods: Cross-sectional survey assessing benefits, barriers to PPC, and consultation processes. Results: Of 291 eligible respondents, 48% ( n = 140) completed the survey and 16% ( n = 47) answered an open-ended question. Benefits included support in decision-making ( n = 98; 70%) and identification of goals of care ( n = 89; 64%). Barriers included perception of giving up on families ( n = 59; 42%) and poor acceptability by other team members ( n = 58; 41%). Respondents endorsed communication with the primary ICU team before ( n = 122; 87%) and after ( n = 129; 92%) consultation. Open-ended responses showed more positive (79% vs. 13%) than negative statements. Positive statements reflected on expanding PPC to other critically-ill children where negative statements revealed unrecognized value in PPC. Conclusions: Results demonstrate opportunities for education about the scope of PPC and improvements in PPC delivery.
Keyphrases
- palliative care
- extracorporeal membrane oxygenation
- acute respiratory distress syndrome
- intensive care unit
- advanced cancer
- mechanical ventilation
- respiratory failure
- young adults
- healthcare
- decision making
- primary care
- machine learning
- quality improvement
- deep learning
- physical activity
- depressive symptoms
- cross sectional