P0538 - Enhanced Communication through Virtual Interdisciplinary Team Rounds for Pediatric Patients Receiving Hospice Care in Outlying Communities

I.

Background: Providing hospice/palliative care (HPM) for children in the community is
challenging due to limited numbers of experienced clinicians outside of medical centers.
In rural areas, pediatric HPM is almost non-existent, although adult providers attempt to
care for children referred to them. Telehealth has been used effectively for patient
follow up.

II. Aim Statement: Our goal is to extend the reach of existing pediatric HPM clinicians
to provide team oversight and consultation to adult organizations providing pediatric
HPM care.

III.

Methods: Virtual Pediatric Consultative Rounds (VPCR) were developed with a
large community-based adult HPM partner with nine regional offices. Each regional
office typically cares for 1-5 children. A rounding sheet was developed to collate clinical
information to enhance efficiency of VPCR sessions. VPCR sessions utilizing Skype for
Business (HIPPAA compliant) were scheduled every other week for two hours
beginning in July 2018. The hospital-based pediatric HPM team and the communitybased
coordinators were on-line as each nurse presented medical/psychosocial issues,
medication reconciliation, code status, hospital/ED visits, follow-ups and goals. 5-10
minutes per patient was alotted including a short dialog/Q&A. Patient records were
updated for both institutions and changes noted. An online survey was developed to
assess the nurses' experiences with the VPCR process ranging from 1(strongly
disagree) to 5 (strongly agree).

IV.

Results: Nine pediatric nurses participated in the VPCR initiative and seven
completed the survey. Most nurses used a corporate cellphone for reporting; whereas,
two used laptops with televideo when able. After an initial learning curve for logins,
participants found the technological interface acceptable with good-to-excellent audio
and video quality.
VPCR participation: (Likert 1-5)
-Allowed better patient care 3.86
-Facilitated better care coordination 4.0
-Improved communication w/ family 3.86
-Reduced ER visits/hospitalization 2.57
-Enhanced dialog with referring MD 4.29
-Improved understanding of MD's plan 3.71

V. Conclusions and Implications: VPCR improves communication between referring
hospitals and community providers, facilitates problem solving and a sense of
professionalism.