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Purpose: Demand for generalist health professional knowledge and skills in pediatric palliative care (PPC) is growing in response to heightened recognition of the benefits of a palliative approach across the neonatal, pediatric, adolescent and young adult lifespan. This study investigates factors that enhanced PPC workforce capability and education outcomes in metropolitan and regional areas through the integration of dedicated educator roles within specialist pediatric palliative care (SPPC) teams through a national education project. Methods: Cross-sectional, prospective qualitative study guided by the Consolidated Criteria for Reporting Qualitative Studies. The study drew on Discovery Interview methodology and transcripts subjected to inductive thematic analysis. A convenience sample (n=16) of health professionals and educators were recruited from specialist tertiary and regional services providing PPC in Australia. Results: Four themes emerged related to outcomes of the national PPC education project: (1) building capability in PPC, (2) developing inter-professional partnerships, (3) sustaining staff well-being, and (4) learning from children and families. Dedicated educator roles in SPPC services enhanced workforce capability through education and ongoing mentoring, built collaborative relationships between the complex network of care providers for children with a life-limiting condition (LLC) and their families, and improved quality and access to PPC. Delivery of education evolved from didactic to interactive engagement and coincided with development of a mentoring model between SPPC clinicians and generalist health and social care providers. Conclusion: This study contributes to a growing body of knowledge on innovative and responsive mechanisms for enhancing workforce capability in PPC and provides additional evidence to support funding of dedicated educator roles in specialist PPC services.

Leigh A Donovan,1 Penelope J Slater,2 Sarah J Baggio,3 Alison M McLarty,3 Anthony R Herbert3,4   On behalf of the Quality of Care Collaborative Australia1Bereavement Service, Queensland Children’s Hospital, Children’s Health Queensland, Brisbane, QLD, Australia; 2Oncology Services Group, Queensland Children’s Hospital, Children’s Health Queensland, South Brisbane, QLD, Australia; 3Paediatric Palliative Care Service, Queensland Children’s Hospital, Children’s Health Queensland, Brisbane, QLD, Australia; 4Centre for Children’s Health Research at Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, AustraliaCorrespondence: Penelope J SlaterOncology Services Group, Queensland Children’s Hospital, Children’s Health Queensland, 12b, 501 Stanley St, South Brisbane, QLD 4101, AustraliaTel +61 7 3068 5785Email penny.slater@health.qld.gov.auPurpose: Demand for generalist health professional knowledge and skills in pediatric palliative care (PPC) is growing in response to heightened recognition of the benefits of a palliative approach across the neonatal, pediatric, adolescent and young adult lifespan. This study investigates factors that enhanced PPC workforce capability and education outcomes in metropolitan and regional areas through the integration of dedicated educator roles within specialist pediatric palliative care (SPPC) teams through a national education project.Methods: Cross-sectional, prospective qualitative study guided by the Consolidated Criteria for Reporting Qualitative Studies. The study drew on Discovery Interview methodology and transcripts subjected to inductive thematic analysis. A convenience sample (n=16) of health professionals and educators were recruited from specialist tertiary and regional services providing PPC in Australia.Results: Four themes emerged related to outcomes of the national PPC education pr

Purpose: The Quality of Care Collaborative Australia (QuoCCA) provided pediatric palliative care education across Australia with the aim of improving the quality of services. The education was delivered through a collaboration of six tertiary pediatric palliative care services, through funding for Nurse Educators, Medical Fellows, a National Allied Health Educator, and national project staff. Methods: Pre-and post-education surveys were completed by participants immediately following the education, and confidence and knowledge were measured along nine domains related to the care of the child and family, including managing a new referral, symptom management, medications, preparing the family, and using local agencies. Results: Education was provided to over 5,500 health and human service professionals in 337 education sessions across Australia between May 2015 and June 2017. Paired pre-and post-surveys were completed by 969 participants and showed a significant improvement in all the domains measured. Those with no experience in caring for children receiving palliative care showed greater improvement following QuoCCA education compared to those with experience, although the latter had higher scores both before and after education. Similarly, those with no previous education showed greater improvement, but those with previous education showed higher scores overall. Participants in full-day and half-day sessions showed greater improvement than those in short day sessions. Thus, the dosage of education in the length of the sessions and prior attendance impacted knowledge and confidence. Topics requested by the participants were analyzed. Educator learnings were that education was more effective when tailored to the needs of the audience, was interactive, and included story-telling, case studies, and parent experiences. Conclusion: These results encouraged the continuation of the provision of education to novice and experienced professionals who care for children with

Penelope J Slater,1 Anthony R Herbert,2,3 Sarah J Baggio,2 Leigh A Donovan,2 Alison M McLarty,2 Julie A Duffield,4 Lee-anne C Pedersen,2,3 Jacqueline K Duc,2 Angela M Delaney,2 Susan A Johnson,2 Melissa G Heywood,5 Charlotte A Burr6 On behalf of Quality of Care Collaborative Australia 1Oncology Services Group, Queensland Children’s Hospital, Children’s Health Queensland, South Brisbane, QLD, Australia; 2Paediatric Palliative Care Service, Queensland Children’s Hospital, Children’s Health Queensland, QLD, Australia; 3Centre for Children’s Health Research at Institute of Health and Biomedical Innovation, Queensland University of Technology, QLD, Australia; 4Paediatric Palliative Care Service, Women’s and Children’s Health Network, Adelaide, SA, Australia; 5Victorian Paediatric Palliative Care Program, The Royal Children’s Hospital, Melbourne, VIC, Australia; 6Western Australia Paediatric Palliative Care Service, Perth Children’s Hospital, Perth, WA, Australia Purpose: The Quality of Care Collaborative Australia (QuoCCA) provided pediatric palliative care education across Australia with the aim of improving the quality of services. The education was delivered through a collaboration of six tertiary pediatric palliative care services, through funding for Nurse Educators, Medical Fellows, a National Allied Health Educator, and national project staff.Methods: Pre- and post-education surveys were completed by participants immediately following the education, and confidence and knowledge were measured along nine domains related to the care of the child and family, including managing a new referral, symptom management, medications, preparing the family, and using local agencies.Results: Education was provided to over 5,500 health and human service professionals in 337 education sessions across Australia between May 2015 and June 2017. Paired pre- and postsurveys were completed by 969 pa

Parents whose child dies from cancer experience a complex layer of losses: that of their child, pre-existing formal and informal relationships in their community, and the loss of what some term, the ‘hospital family’. Adopting a mixed method analysis (N=119 self report-questionnaire; n=41 semi-structured interview), this thesis examined this dilemma from a systemic perspective acknowledging the relationship between all three of these components which impact on a family’s experience of bereavement. Study one explored bereavement follow up practices in the paediatric oncology setting. Staff demonstrated a commitment to providing follow up bereavement care for families following the death of a child, however also described logistical and fiscal limitations in service delivery. Study two focused on the intra-personal components of parental grief examining the impact of demographic and medical factors on parents’ bereavement. This study confirmed medical components of a child’s cancer care trajectory had a profound impact on bereavement for a proportion of parents. Parents’ gender, religious affiliation and education level have a significant impact on levels of growth. Study three explored the inter-personal assets in the lives of families before and after the death of their child. Distancing from the local community and engaging more fully with the treatment team and other peers meant for many families a new community of support was established in the hospital. In bereavement, parents’ expectations of ongoing care from the treatment team were often not met. Simultaneously, parents described barriers to accessing formal and informal support, feeling the need to ‘maintain face’ within their social networks; feeling the privacy of their experience inhibited their capacity to seek support; and simply not knowing where or how to access support. These findings affirm the need to target psycho-social support at critical intervals throughout a child’s cancer care trajectory and

Background: Pediatric palliative care is an evolving specialty that aims to improve the lives of children with a life-limiting condition. As an emerging specialty, there is much to be learned about service provision and the expected outcomes that can be achieved. Additionally, quantification of the needs for pediatric palliative care is complicated by the uncertainty of defining the population that requires care. Objectives: Our aim was to define the characteristics of the population cared for by a newly formed state-wide service in Queensland, Australia, and describe the development of the service over a 24-month period. Design: Data on all referrals and outcomes were collected. Descriptive statistics were used to describe patterns including the variation in outcomes between children with oncology and non-oncology diagnoses. Other factors influencing the development of the service including involved health professionals and the model of the Australian health care system are also described. Results: Over a 24-month period, 150 patients were referred of whom 117 subsequently died. There was a wide range of diseases and ages, and significantly, 58% of children were from regional or rural locations where there are can be limited access to specialist pediatric services. The average length of service was 83 days. A variety of factors were identified as being important for providing optimal care including ensuring equity in access, timing of referral, and continuity of care. Conclusion: The importance of a population-based approach to pediatric palliative care in a state that is geographically large and diverse like Queensland is highlighted. This article may provide valuable information to other health care providers who care for children with life-limiting illnesses.