Study finds, Quality measures for end-of-life care for child
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Quality metrics have improved the quality of adult end-of-life cancer treatment, but there are no comparable measures for children. As a result, the authors recommended EOL(end-of-life) quality measures for pediatric oncology using a validated expert panel system.

The authors used the modified Delphi method to assess potential quality measures. Panelists were selected on the basis of professional organization nominations and expert qualifications. Pediatric and adult oncology, pediatric palliative care, social work, nursing, and hospice were represented. The authors provided the panel with a literature review on 20 proposed measures derived from adult measures and bereaved family interviews.

The panel first scored the importance of each measure on a 9-point scale and then discussed the measures via a conference call. The panel then rescored the measures. According to a priori standards, measures with median scores more than 7 with at least 7 of 9 experts ranking it as more than 4 were endorsed.

Results:
--The 16 endorsed measures included measures related to avoidance of medically intense care (eg, intensive care unit death and intubation in the last 14 days of life), death location (eg, death in the preferred location), hospital policies/programs (eg, the removal of visitor restrictions at EOL and the presence of a bereavement program), and supportive care services (eg, pediatric palliative care involvement and sibling needs assessment).
--Unendorsed measures included avoidance of chemotherapy at EOL and home death.

Finally, quality measures for EOL treatment in pediatric oncology have been established with the approval of an expert group. Before they can be used in the real world as a method for standardizing EOL treatment in pediatric oncology, the interventions must be validated with bereaved families and refined further.

Source: https://acsjournals.onlinelibrary.wiley.com/doi/10.1002/cncr.33546
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