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CAPC Palliative Care Discussion Forum
Pediatric Palliative Care

Next Reply: Re:Triggers
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Author: StacyRemke [CAPC/PCLC Faculty]
Date: Apr 9, 2009 12:32 pm
Hi. Our program has had success with negotiating with several specialty groups which kinds of children they agree are appropriate for palliative care. While this is not a list, it has gone a long way to help establish effective relationships and trust. Once our PPC team has demonstrated a collaborative approach, and some "value added" that is appreciated by the specialty group as well as families they seem more receptive to expanding the types of situiations they refer. Plus we can provide soem one on one education re: palliative care as we go. We tried piloting a list to some of our colleagues in the hospital, and got quite a bit of push back, so have scaled back our plans a bit, and while we do plan to establish a trigger list in future, we see we need to work on these trust and education issues a bit more first.
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Re:Triggers (by michellefrost on 07/02/2009)
We have had great success with triggers for palliative care consults and appreciate the upfront work and buy-in necessary to sustain these triggers. Currently we receive automatic referrals on the following:
- All pediatric bone marrow and stem cell patients
-All relapsed sarcoma patients
-All brain stem glioma patients (at diagnosis)
-All patients who are put on ECMO
-All neuro-oncology patients with a less than 25% survival rate at diagnosis

We are seeing a growing number of consults from Neurology and the Spinal Dysplasia Clinics but have yet to establish true triggers in these areas.


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