Circles of Influence 2008

Organization:  Pain and Palliative Care Program, Children’s Hospitals and Clinics of Minnesota, Minneapolis/St. Paul, MN.  Innovation highlights noted were a three-part focus on pain management/palliative care, end-of-life care, and integrative medicine; emphasis on “follow the kid;” and state and local infrastructure for leadership in palliative and end-of-life care.

Recent Achievements:   The home-based palliative care, perinatal hospice, inpatient consultation, and clinic provide a strong platform for the education and outreach.

Children's offers a wide range of educational opportunities.  The Annual International Pediatric Pain Master Class is an intensive high-level six-day workshop for prescribers focusing on pharmacological and non pharmacological interventions for children with acute/chronic or complex pain issues and palliative care needs.  It is one of the few specific high-level seminars offered on this topic.  Other services provided are "just in time" education, 24-hour clinical support line, inservices, and professional conferences which have supported growth and development of individuals and programs nationally and internationally in promoting the provision of pediatric palliative care.  The program provides a fellowship for physicians and is in the final stages of completing work with EPIC to produce a palliative care curriculum for pediatric oncologists.

The organization is a CAPC Palliative Care Leadership Center.

As the program continues to expand all of its services, it has collaborated nationally to serve children and families across the country.  The national collaboration's web site is www.network4pedspallcare.org.  Children's continues to work with the state Department of Human Services to effectively implement the recent health care reforms and find ways to improve care and quality.

Award Impact:  Staff and volunteers were incredibly proud.

Receiving the Circle of Life Award also improved contacts in palliative and end-of-life care community—providing better information exchange and staff networking. Immediately after receiving the award and for six to nine months afterwards, the hospice was contacted by organizations from around the nation, seeking advice and information needed for following its model.

Organization:  Haven Hospice, Gainesville, FL. The hospice’s innovations include a pharmacy and therapeutics committee, outreach to minority populations, and work on outcome indicators.

Recent Achievements: Haven Hospice continues to develop creative ways to extend service to the many rural communities in its 19-county service area. Haven’s efforts in this regard have gained national attention. The University of Virginia School of Nursing used data provided by Haven in a study that was awarded the Ruth Lanford Research Award for research in rural communities. The research compared patient and family satisfaction with hospice care and examined associations between satisfaction and patient demographics, rural or urban location, and the content of hospice care. Haven’s 562 employees and more than 1,000 volunteers allow it to provide comfort, care and compassion to patients and families in the most remote communities.

Haven has continued its work to provide more access to hospice services for the parts of its service area with high minority populations, and has doubled its census there. Haven has also been able to assist minority populations through Transitions, a support program for those facing a serious illness that are not ready to commit to hospice services; grief support counseling programs; and Camp Safe Haven, a day camp for children and teens who have lost a loved one. Haven expanded the Camp to include a day for adults that have experienced a loss. Haven provides a broad range of services to meet the diverse needs of patients and families in end-of-life and palliative care.

In October 2015, Haven completed an affiliation with Hospice of Florida Keys to provide direction and assistance in insuring that hospice services continued to be available to the residents of Monroe County. Haven now serves nineteen Florida counties with the majority being rural.

Haven added an additional patient care center and expanded the care centers in Palatka and Gainesville to meet the growing need within their service area. Plans are underway to construct a sixth care center in Jacksonville to be operational by 2018.

The Workplace Counseling Program is benefiting more and more businesses throughout north Florida. Haven’s Caring Connections provides on-site grief counseling programs and support groups for employees who are maintaining full time jobs while being caregivers for family members or friends with life-limiting illnesses.

Award Impact:  Staff and volunteers were incredibly proud. 

Receiving the Circle of Life Award also improved contacts in palliative and end-of-life care community—providing better information exchange and staff networking.  Immediately after receiving the award and for six to nine months afterwards, the hospice was contacted by organizations from around the nation, seeking advice and information needed for following its model.

Organization:  Pediatric Advanced Care Team, Children’s Hospital of Philadelphia, Philadelphia, PA.  Innovation highlights noted were staffing models with physicians from different specialties, research to develop metrics, and focus on continuum of care.

Recent Achievements: The home visit program and bereavement support service have grown tremendously, and we have added two additional social workers to the team.  We have also divided the clinical consultative service into inpatient and outpatient teams, and now have four full-time attendings to staff these teams.  This growth has allowed us to provide increased support to patients and families in the home.

The pediatric fellowship program has now trained 15 fellows, having expanded to training two per year, and our fellows are now working in programs all over the country.  We have also had fellows combine specialties with critical care, oncology and psychiatry, adding to the breadth of knowledge within the field. We continue to mentor our former fellows in presentations at national meetings and research collaborations.

We have trained 14 pediatric faculty at the institution (in multiple specialties) in the Vital Talk communication skills training methodology, and now have the largest cohort of pediatrician-facilitators in the country.

We are collaborating with Children’s Hospital in Boston in an NIH funded multi center study of symptom management and psychosocial outcomes for pediatric palliative care patients and their families, under the leadership of our director of research, Dr. Chris Feudtner.

We have increased our philanthropic support, with multiple endowments now in place, and have also grown in clinical billing to support these programs.

We have integrated our services throughout the institution and are now well-accepted in all areas, including having been invited to meet all potential heart and lung transplant recipients by their respective programs.

We have instituted a yearly strategic planning retreat to manage team growth and direction, which has helped us continually examine our programs and our future.

In the 2018-2019 academic year, we are starting an innovative psychosocial fellowship program, with a child life specialist signed on to be our first fellow.

Award Impact: The Circle of Life Award raised awareness of team achievements in the hospital, locally, and regionally.  The award was highlighted in all fundraising.  It has been helpful in fundraising (donors always ask about recent recognition) and gives the program national standing.

The long, substantive application process helped the program take an overall look at itself--it is useful to put on paper what exactly is being done.  It also enabled the team to focus on the program’s strengths. The site visit gave impetus to focus on innovation.

Pediatric palliative care is relatively new and the award helps give that field stature.