Bloomberg Nursing Assistant Professor Kimberley Widger has recently obtained funding to advance palliative and end-of-life care for children all across Canada. The Palliative and End-of-Life Care Initiative grant, funded by the Canadian Partnership Against Cancer (CPAC) will allow Widger and co-lead Dr. Adam Rapoport at Toronto’s Hospital for Sick Children to implement a national roll-out of Education in Palliative and End-of-Life Care for Pediatrics (EPEC®-Pediatrics), an innovative evidence-based program specifically designed for pediatric oncology physicians and advanced practice nurses.
Even with improvements in treatment, childhood cancer remains a leading cause of non-accidental death in children. Of the approximately 10,000 children living with cancer in Canada, more than 200 will die from the disease this year. Palliative care for children focuses on alleviating the physical, social, psychosocial, and spiritual suffering experienced by children while also promoting quality of life, fostering family connections, and sustaining hope despite the lingering possibility of death.
There is growing evidence that pediatric palliative care programs improve the quality of care provided to children and their families at end-of-life, and it is now widely endorsed that principles of palliative care should be included in the routine care of all children diagnosed with cancer, and not only for those children at the end-of-life. However, many pediatric health professionals report receiving little training specific to palliative care which has contributed to reports from families of less-than-optimal care throughout the course of the disease.
Widger and her team aim to improve health care provider knowledge by using a train-the-trainer education model. The EPEC®-Pediatrics curriculum will ensure that Regional Teams representing oncology, palliative care, and the community from each of the 16 pediatric oncology programs across Canada receive comprehensive education about evidence-based palliative care while also acquiring the tools to teach others. Upon completion of the curriculum, Regional Teams will become EPEC®-Pediatrics Trainers, with the knowledge and tools to disseminate all aspects of the curriculum to other healthcare providers. Trainers will be supported by the project team to implement new knowledge and skills and lead quality improvement projects in their local communities with a goal of improving the quality of palliative and end-of-life care for children with cancer.
“Even with the fantastic improvements in finding cures for childhood cancer, families still face the ever present fear of death, and children must endure endless painful procedures and side-effects from the treatments aimed at attaining that cure,” says Widger. “From the time of diagnosis, families need to receive care from health professionals who understand and apply the principles of palliative care to address the fears and improve quality of life not only for the child, but for mothers, fathers, brothers and sisters as well. In particularly challenging situations or when cure is not possible, earlier referrals to specialized palliative care teams have the potential to improve the quality of care.”