SHARING ABOUT CARING: The Roger’s House Interdisciplinary and Inter-Organizational Mentorship for Pediatric Palliative Care Initiative 2007

Lynn Grandmaison Dumond RN(EC), M.Sc.N., Lloyd Cowin, M.H.A., Marion Rattray, RN, William Splinter, B.Sc., MD, FRCP(C)

Acknowledgements: A sincere thank you to our mentors from the Canuck Place Children’s Hospice, the Hospice at May Court and the IWK Health Centre Pediatric Palliative Care Service for generously “Sharing about Caring”. Thank you also to the Inter-professional Mentorship, Leadership and Coaching (IMPLC) Fund sponsored by the Ontario Ministry of Health and Long term Care, Nursing Secretariat and the Children’s Hospital of Eastern Ontario.

Roger’s House (Ottawa) A free-standing pediatric hospice affiliated with the Children’s Hospital of Eastern Ontario and the Ottawa Senators Foundation. It provides services for children with life limiting illnesses and their families.

Canuck Place Children’s Hospice provides pediatric palliative care for children and their families living with life limiting illness. Located in Vancouver, it is North America’s first free- standing children’s hospice.

Mentoring Content

•Clinical programs, processes, structures, procedures, tools

•Partners and supports

•Professional roles and responsibilities

•Inter-disciplinary team model

•Pediatric palliative care

•Innovative delivery of care: Madison Clinic

Mentoring Activities

•Presentations, role playing, rounds, site visit

•Expert panel discussion

•Case presentation and review

•Canuck Place 3rd Annual Pediatric Palliative Care Workshop

•Clinical documents and tools

The Hospice at May Court (Ottawa) provides support for adult patients and their families facing a life threatening illness. Services are offered in the Residence, Family Support, Day Hospice, and Home Support programs.

Mentoring Content

•Adult hospice’s 4 programs

•Staff and volunteer: hospice experience

•Clinical exposure: In hospice care of adults

•Local/community and provincial supports

•Resources

Mentoring Activities 

•Presentations

•Expert panel by Hospice volunteers

•Clinical immersion at the Hospice

•Home visits

•Discussion with staff

The IWK Pediatric Palliative Care Service (Halifax) provides collaborative care in the Maritimes to children and families within the Health Centre and in their home communities.

Mentoring Content•Outreach, inter-provincial considerations •Community partnerships, team building•Bereavement support and resources•Professional boundaries, staff recognition•Research•Music Therapy•Seamless continuum of care

Mentoring Activities•Grand Rounds: “Critical Communication in Pediatric Care”

•Lunch and Learn - Music Therapy•Team and clinical rounds •Formal and informal presentations,role play•Case presentation and review•Profession specific break out sessions

Key Points/Concepts to Integrate

•Bereavement support throughout the illness trajectory

•Scrapbooking program, Child life

•Acuity and work load measurement

•The 4 quadrants model

•Intake and family meetings

•Definition of roles and responsibilities

•Outpatient Clinic

Key Points/Concepts to Integrate

•Further develop volunteer role in hospice

•Expand community outreach

•Explore and develop hospice day program

Key Points/Concepts to Integrate

•Care provision at a distance

•Inter-provincial collaboration

•Comfort Cart

•Bereavement resources

•Perinatal hospice

•Expand Child Life: Music Therapy

•Staff recognition

OutcomesCollegiality

Collaboration Team building

Partnership EstablishmentInterdisciplinary Participation

Overwhelming Participant SatisfactionValidation of Shared Practices, Beliefs

and Feelings

Participation and Satisfaction

•Project timeline: 5 mos.

•Organizations involved: 4

•Mentoring Sites: 4

•Mentoring Days: 12

•Participants: 171

•Mentors: 49

•Mentored: 118

•Participating professions: 12

•Participating partners: 2

Participant Quotes

“We appreciated the opportunity to network and learn from a similar organization” . IWK Mentor

“The presenters were exceptional… dynamic, knowledgeable, interesting… and the information conveyed was relevant”. Roger’s House staff

“Learning was enhanced by sharing… excellent… all very pertinent… a rewarding experience”. We are enlightened and “energized” to “see where we might be in the future”. Roger’s House staff

Spending time with the Roger’s House staff “highlighted” for me “the exceptional care” I give to my patients. Hospice at May Court Mentor

“The good things being done at Roger’s House (were) confirmed” by our IWK colleagues. Roger’s House staff ‘Learning was enhanced by sharing”. Roger’s House staff

ABSTRACT 

INTRODUCTION: In May 2006 Roger’s House opened its doors. It is one of the few pediatric hospices in Canada and is an integral part of the Children’s Hospital of Eastern Ontario’s Pediatric Palliative Care Outreach Program. In its infancy, this “home away from home” and its staff have much to learn about caring for guests.

The Roger’s House Interdisciplinary and Inter-organizational Mentorship for Pediatric Palliative Care Initiative 2007, funded through the Inter-professional Mentorship, Leadership and Coaching (IMPLC) Fund sponsored by the Ontario Ministry of Health and Long term Care, Nursing Secretariat, brought 4 palliative care agencies together to share their knowledge and skills about caring for children with life limiting illnesses and their families.

PURPOSE: The goals of the initiative included: enhancing clinical skills of professionals, clarifying roles and responsibilities, enhancing collaborative practice and communication between team members, improving program processes, structure and procedures and developing relationships among like colleagues to enhance sharing of clinical experience and research ideas.

METHODS: A short written survey evaluated the achievement of goals immediately following each seminar.

RESULTS: Participants from 4 organizations attended a total of 12 days of mentoring. Forty-nine per cent of surveys were completed. Results indicate an overwhelming appreciation for the mentoring opportunity and achievement of goals.

CONCLUSION: Participation in this multi-organizational, interdisciplinary mentoring initiative was beneficial to all. Collaboration, collegiality, team building and validation of shared practices were experienced and set the stage for future partnerships.