P3B038: Improving Care for All: A Primary Palliative Care Champion Curriculum Focused on Care in the CTICU for Latino/a/x Families

Background: Expanding knowledge of pediatric palliative care (PC) and deepening the primary PC skills of clinicians working with children with serious illness helps assure more patients receive child- and family- focused care that addresses their quality of life while they are receiving medical treatments. Expanded primary PC skills can also improve appropriate utilization of the limited capacity of most subspecialty PC teams. In addition, high quality primary PC requires attention to inequities in health care, implicit bias and cultural humility. The PC “Champion” model, in which non-sub-specialist providers receive and then disseminate education and training in primary PC, is a promising mechanism to expand access to PC and complement subspecialty PC services. With the goals of increasing primary PC skills, maximizing utilization of subspecialty PC and addressing inequities in care of Latino/a/x patients and families, we piloted a primary PC Champion program in a high need area of our children’s hospital, with an integrated focus on cultural humility and health equity.

Methods: With stakeholder and bereaved parent partnership, an interprofessional planning team developed a primary PC Champion program in the Cardiothoracic Intensive Care Unit (CTICU). A nine-month curriculum was developed focusing on primary PC skills, cultural humility and responsiveness in caring for Latino/a/x patients. Sessions addressing trauma informed care, moral distress and clinician sustainability were included. A “toolkit” of primary PC resources, targeted for future use by the Champions, was built in partnership with the sub-specialty PC team.

Results: Thirteen interprofessional CTICU clinicians were selected into the program out of a pool of applicants. Champions took part in didactic education and self-directed learning over nine months, with 85% of participants attending more than 90% of the sessions. In response to input from the Champions, session length was increased and additional time for group reflection was provided. Compared to baseline, self-reported confidence in providing primary PC increased after participating in the program (see Table 1). Champions reported that participating in the program significantly changed their practice and decreased their sense of work-related distress (See Figure 1).

Conclusion: The Champion model can be an effective and feasible way to promote primary PC skills, deepened training in culturally humility; and increased ability to provide staff support. Having a curriculum that leveraged the strengths/skills of the subspeciality PC team and other institutional interprofessional experts as well as being responsive to Champions’ needs enhanced program feasibility and acceptability. Ongoing efforts focus on collecting data to support future educational and quality improvement efforts, supporting continued activities of the Champions, and adapting this novel programming into additional clinical units throughout the institution.