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. 2009 Jul;14(6):379-84.

The Madison Clinic: Evaluation of a collaborative outpatient paediatric palliative care clinic

Harold Siden  1 , Lynn Straatman, Tanice Miller, Jennifer Ham
Affiliations

The Madison Clinic: Evaluation of a collaborative outpatient paediatric palliative care clinic

Harold Siden et al. Paediatr Child Health. 2009 Jul.

Abstract
in English, French

Background: A multidisciplinary outpatient clinic at a tertiary care children's hospital supported and staffed by a children's hospice was created to enhance and expand the inpatient palliative care services available to families of children with life-limiting conditions. This clinic was created with input from clinicians, program leaders and families in developing the goals and format.

Method: The clinic was evaluated with indicators that included program data from palliative care consultations. This information was collected and recorded on a prospective basis.

Results: In the first 29 months of operation, 43 clinics were held, 39 individual patients were seen and there were 59 visits. The majority of visits were for pain and symptom management (75%), while 20% were for assessment for the hospice program. The hospice-palliative care team also provided telephone support, videoconference support and inpatient consultations. Patients reported overall satisfaction with their experiences at the clinic.

Discussion: A major benefit of this outpatient palliative care clinic is its ability to offer continuity of care for patients and their families. It also serves as a preliminary introduction to palliative care, particularly significant for families who are not yet ready to learn about or engage in the full hospice program.

HISTORIQUE: La clinique ambulatoire multidisciplinaire d’un hôpital de soins tertiaires pour enfants soutenue et dotée en personnel par un centre de soins palliatifs pour enfants a été créée pour améliorer et accroître les services de soins palliatifs aux patients hospitalisés offerts aux familles d’enfants atteints d’une maladie limitant leur durée de vie. Pour mettre cette clinique sur pied, des cliniciens, des chefs de programme et des familles ont participé à l’élaboration des objectifs et de la structure.

MÉTHODOLOGIE: Les auteurs ont évalué la clinique au moyen d’indicateurs qui incluaient les données du programme tirées des consultations en soins palliatifs. Ils ont colligé et consigné l’information sur une base prospective.

RÉSULTATS: Au cours des 29 premiers mois d’exploitation, la clinique a été tenue 43 fois, 39 patients ont consulté, et 59 visites ont été organisées. La majorité des visites visaient la prise en charge de la douleur et des symptômes (75 %), tandis que 20 % visaient l’évaluation du programme de soins palliatifs. L’équipe de soins palliatifs a également offert un soutien téléphonique, un soutien par vidéoconférence et des consultations aux patients hospitalisés. Dans l’ensemble, les patients se sont dits satisfaits de leur expérience à la clinique.

EXPOSÉ: L’un des grands avantages de cette clinique ambulatoire de soins palliatifs, c’est sa capacité d’offrir des soins continus aux patients et à leur famille. Elle permettait également de faire connaître les rudiments des soins palliatifs, ce qui était particulièrement important pour les familles qui n’étaient pas encore prêtes à découvrir le programme complet de soins palliatifs ou à y participer.

Keywords: Ambulatory care facilities; Continuity of patient care; Paediatrics; Palliative care.

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