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Pediatric Palliative Care

In Reply To: Pediatric Palliative Care in the Home
Next Reply: Re:Re:Pediatric Palliative Care in the Home
Previous Message: Re:Pediatric Palliative Care in the Home

Post Re:Pediatric Palliative Care in the Home
Author: sfriebert
Date: Jun 9, 2008 8:34 pm
Hi Shelley, I don't know what state you are in -- sometimes state regs can affect what would be the best choice. For pediatrics, the issues are very different, as was pointed out -- but to your specific question, you could look at where most of your referrals are landing, how best to preserve continuity and trust (and it sounds like you have a plan to do that with the same team) and, obviously, reimbursement issues. Many programs opt to house pediatrics within home care to offer the full continuum, and cross-train the pediatric team in hospice care. Others use more broad entry criteria for their hospice programs when it comes to pediatrics. Is your organization looking to revise its current reporting structure at all?
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Re:Re:Pediatric Palliative Care in the Home (by shelley on 06/11/2008)
Hi Sarah- Thanks for your reply. I am in NC. I think that the dilemma is that it makes sense to put pediatrics in hospice because what we are proposing to do is provide hospice level of care without requiring traditional adult hospice admission criteria. Then it makes sense to put pediatrics in home health because that's where most of our reimbursement (whatever reimbursement we get) will come from. Our exec director has stated that she does not want for the pediatric program to conform to our current structure and would like for it to be a more integrated program (home health and hospice), but she does not want to change our current hospice/home health reporting structure. I am the program coordinator/social worker and I report to Director of Hospice. Our designated nurse reports to home health. We pull other staff (chaplain, therapies) in as needed. This reporting structure is not working well. I have thought that maybe what works is for Pediatric coordinator to report to executive director and have other staff report to either home health or hospice depending on how their position is shared. However, this structure seems to lend itself more readily to turf battles. Perhaps there is no "right" answer and we'll simply have to try something and modify it as needed.

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