Publication
The ROAR Score: Quantifying Risk of Acute Return to the Hospital in Pediatric Hospice Patients
Maddox K, Newcomer K · Journal of Pain and Symptom Management · 2024
Outcomes: 1. Implement a scoring system to facilitate clear and concise communication of goals of care between palliative care teams, hospice staff, and families. 2. Understand the benefits of a scoring system for hospice staff to mitigate family distress and provide timely and appropriate recommendations for uncontrolled symptoms, particularly outside of regular business hours. Key Message: Pediatric Medicaid allows patients and their families to continue all levels of care when electing the hospice benefit under the concurrent care model. We created the ROAR Score (Risk of Acute Return) to help accurately and concisely convey the family's goals to hospice staff when offering recommendations for symptom management. Introduction: Goals of care for patients electing the pediatric hospice benefit often vary widely. Some families don't want to return to the hospital ever, while others continue to utilize emergency and hospital services for their child until the end of life. This presents a challenge to hospice staff, many of whom are more familiar with the traditional adult model of hospice care. They often struggle with how to advise caregivers in the treatment of their child, particularly after hours when the primary nurse may not be available. Method(s): A scoring system was developed (ROAR Score: Risk Of Acute Return to the hospital) to create a concise, easily identifiable summary of a family's goals so hospice staff can better advise caregivers. The score is to be assigned by the referring palliative team, and updated by the hospice team regularly as family goals evolve. The score indicates a family's goals ranging from care focused exclusively on comfort to a desire to return to the hospital for any complication. Result(s): Hospice staff surveyed 3 months post implementation of the ROAR score indicated improved understanding of goals of care and increased confidence in providing recommendations. Conclusion(s): Use of a ROAR Score helped palliative and hospice teams quickly ascertain and communicate family goals of patients on hospice utilizing concurrent care. Keywords: Shared Decision Making / Advance Care Planning / Interdisciplinary Teamwork / ProfessionalismCopyright © 2024
Synced from the TRENDS in Pediatric Palliative Care Zotero library, curated by The Siden Research Team. ICPCN does not host or verify the full text.