Grossoehme Daniel H, Mark Melissa S, Lane Blake, Rednour Allison, Thienprayoon Rachel
Haslinger Family Pediatric Palliative Care Center, Akron Children's Hospital, Akron, Ohio.
Rebecca D. Considine Research Institute, Akron Children's Hospital, Akron, Ohio.
Pediatr Qual Saf. 2020 Jul 8;5(4):e317. doi: 10.1097/pq9.0000000000000317. eCollection 2020 Jul-Aug.
Greater than 70% of children who die in our institution annually die in an intensive care unit (ICU) setting. Family privacy, visitation policies, and an inability to perform religious rituals in the ICU are barriers to provide children with culturally competent, family-centered care when a child dies. The goal of this project was to profoundly understand family and staff experiences surrounding pediatric death in our institution to identify unique opportunities to design improved, novel delivery models of pediatric end of life (EOL) care.
This project utilized a structured process model based on the Vogel and Cagan's 4-phase integrated new product development process model. The 4 phases are identifying, understanding, conceptualizing, and realizing. We utilized an adaptation of this process model that relies on human-centered and design thinking methodologies in 3 phases: research, ideation, and refinement of a process or product opportunity.
There were 2 primary results of this project: 5 process and opportunity areas to improve the EOL experience across the hospital, and a set of criteria and considerations for a dedicated EOL space.
Sometimes, the best outcome we can provide for a child and their family is a peaceful, dignified death. This project utilized human-centered design to create improved process outcomes and to design a dedicated EOL space for children who die in the hospital. Offering grieving families quiet, private time with their child in a beautiful, dignified, peaceful location enables the beginning of improved bereavement outcomes for the family and staff.
每年在我们机构死亡的儿童中,超过70%是在重症监护病房(ICU)环境中去世的。家庭隐私、探视政策以及在ICU无法进行宗教仪式,这些都是在儿童死亡时为其提供具有文化胜任力、以家庭为中心护理的障碍。本项目的目标是深入了解我们机构中围绕儿科死亡的家庭和工作人员的经历,以确定独特的机会来设计改进的、新颖的儿科临终(EOL)护理提供模式。
本项目采用了一种基于沃格尔和卡根的4阶段集成新产品开发流程模型的结构化流程模型。这4个阶段分别是识别、理解、概念化和实现。我们采用了该流程模型的一种改编形式,它在3个阶段依赖于以人为本和设计思维方法:研究、构思以及对流程或产品机会的优化。
本项目有2个主要成果:5个改善全院临终体验的流程和机会领域,以及一套针对专用临终空间的标准和考量因素。
有时,我们能为孩子及其家庭提供的最好结果是平静、有尊严的死亡。本项目采用以人为本的设计来创造更好的流程成果,并为在医院死亡的儿童设计一个专用的临终空间。为悲痛的家庭提供在一个美丽、有尊严、宁静的地方与孩子共度安静、私密时光的机会,有助于为家庭和工作人员开启改善丧亲之痛结局的开端。