Oral Presentation Palliative Care Nurses Australia Conference 2020

Development of a state-wide approach to goals of care for children (72001)

Rebecca Iten 1 , Dr Lisa Cuddeford 1 , Mary Miller 1
  1. Perth Children's Hospital, Nedlands, WA, Australia

Introduction: Patient and family centred care is essential in advance care planning (ACP) for children with life-limiting and life-threatening conditions, to achieve shared decision making between families and clinicians.1 ACP includes resuscitation planning, goals of end-of-life (EOL) care and considers the values, preferences of the family and child’s best interest.1, 2 In Western Australia, a standardised approach for advance care planning for children did not exist. Implementing a standardised approach across the state would ensure that health professionals are familiar with the framework and format, in addition it would prevent families needing to unnecessarily repeat the information. A Goals of Patient Care (GoPC) framework has been established in the adult health care setting in WA with a GoPC form.

Aim: To develop a state-wide approach to goals of care for children. To ensure that care to children is provided safely and follows family preferences and wishes for EOL.

Approach: A state-wide Paediatric Goals of Patient Care Steering Group convened with representatives from the Child & Adolescent Health Service (CAHS), Metropolitan and Country Health Services, community palliative care provider Silver Chain, the WA Cancer and Palliative Care Network and consumer representatives. Aligning with the adult GoPC format and framework, a form was developed specifically for children. The form was piloted across CAHS over a six-months and feedback from health professionals was sought via a survey.

Outcomes: Following review of the feedback, the form was modified. An outcome from the project was the need for resource development, including simulation workshops to have goals of care discussions. A Clinical Simulation and Training Advisory Network (CSTAN) grant has been obtained to develop an education package and the work is currently underway.

Conclusion: The PGoPC form has been developed by key stakeholders across the state, trialed and modified and is due for roll out across the state in the near future. The state-wide approach is being extended to the development of training and resources through the CSTAN grant. Staff caring for children across WA are committed to a holistic approach to having goals of care discussions and ensuring that information can move between health jurisdictions.

  1. 1. Kelly, J., Ritchie, J., Donovan, L., Graham, C., & Herbert, A. (2018). A Retrospective Review of Resuscitation Planning at a Children’s Hospital. Children, 5(1), 9; https://doi.org/10.3390/children5010009 2. Wolff, A., Browne, J., & Whitehouse, WP. (2011). Personal resuscitation plans and end of life planning for children with disability and life-limiting/life-threatening conditions. Archives of Disease in Childhood Education and Practice Ed, 96, 42-48.