Arizona-based Phoenix Children’s Hospital has developed a pediatric hospice and palliative care fellowship program that is positively impacting access to these services.
An important piece of pediatric palliative clinical education involves developing a deep level of communication skills to help families navigate complicated decision making around serious illness care, according to Dr. Tressia Shaw, palliative care division chief at Phoenix Children’s.
Communication skills are among the most significant components of shaping a sustainable pediatric palliative care workforce, Shaw said.
“A big skill that often comes out of [pediatric] palliative care training is the communication skill set,” Shaw told Palliative Care News. “That higher-level communication skill set to navigate layered and sometimes complicated decision making situations is really important. Making sure you’re on the same page with other specialists and teams is important to coordinating with them as well as with the families. it’s not always something taught in medical school.”
Phoenix Children’s offers primary, palliative and hospice pediatric care. The hospital system provides other services such as orthopedics, ophthalmology, trauma and emergency care and treatment of cancer and blood disorders, among others. Established in 1978, the hospital system has a staff of roughly 800 physicians and advanced practice providers and 1,500 clinicians serving patients across more than 40 locations in Arizona.
Phoenix Children’s palliative program began in 2009 and includes nine physicians, social workers, mental health therapists, child life specialists and bereavement support professionals. Having an interdisciplinary team that is “well-versed” in the different aspects of palliative care has been a “big cornerstone” of developing the pediatric fellowship program, Shaw stated.
The organization’s pediatric palliative and hospice fellowship program launched in 2020. Four medical students have graduated from the fellowship program as of July 2023, with a fifth fellow anticipated this year.
Phoenix Children’s partners with the Hospice of the Valley, the Mayo Clinic Hospital and Ryan House, an Arizona-based pediatric and hospice provider, to offer medical fellows different facility-based learning experiences.
Students go through 12 weeks of training in pediatric hospice and palliative care throughout the course of the fellowship program. The curriculum includes providing consultative services to roughly 300 patient encounters annually and an average daily census of more than 40 patients.
“There’s a lot of different components that go into building a program,” Shaw said. “We really have valued our partnerships with the other teams and specialties. Developing those partnerships with other programs has really built on our ability to reach children and families who need our services. We’ve received a lot of feedback from families and patients of what was helpful to them in this family-centered approach to learning.”
Clinical education programs like these are needed to help grow and prepare future pediatric workforces, Shaw stated. Communication skills and pain and symptom management are important in pediatric palliative training, but so too is education around self-care due to the difficult situations providers help families face, she added.
“[With] the fellowship program, we really put a lot of importance on learners and really looking at that next generation of residents [and] teaching and mentoring that next generation,” Shaw said. “It’s about finding a meaning in your work and ways to keep yourself well and not burnout. It’s about training people in this field to have balance and how to navigate that. It’s an important skill set we can teach this generation of learners for long-term viability and sustainability of this work.”