Palliative Care Elective

Introduction

Child neurologists are often involved in the care of patients with life limiting illnesses and are frequently asked to assist in the care of patients who are nearing end of life.  These situations are faced in both the inpatient and outpatient settings and can involve both patients who are familiar to a neurologist and those presenting with acute brain injury. This rotation allows for an immersive experience on the pediatric palliative care team at American Family Children’s Hospital.  There you will gain familiarity with tools and strategies for navigating tender conversations; supporting patients and families in developing treatment plans aligned with their personal values; advocating for patients with their specialty care team; providing spiritual and emotional support; and helping families and patients plan for end of life.  You will have wide latitude in choosing experiences that best match with your career plans.

Schedule

The schedule for this elective will be sent to residents in the weeks preceding the rotation. The rotation is composed of a daily team huddle, rounding with the physicians and APPs and additional optional multidisciplinary experiences. On the first day of the rotation you will meet with the attending on service at 10:30 in WIMR 4133 to discuss goals of the rotation.

Patient Care

 Goals

Residents must demonstrate the ability to participate in discussions regarding end of life care and provide family centered patient care for those with life limiting diagnoses.

Objectives

Demonstrate an ability to participate in ‘goals of care’ conversation relevant to patients at end of life.

Comprise a management plan for symptoms related to end of life in patients with life limiting neurologic disease.

Medical knowledge

Goals

To enhance knowledge of end of life issues and services available to pediatric patients in those situations.

Learn more about the community resources for children with life limiting diagnoses and those requiring end of life care outside of the hospital.

Objectives

Demonstrate knowledge of available methods of care for patients at end of life, both in the hospital and after discharge including hospice and other in home care.

List the available pharmacologic and non-pharmacologic treatment options used for various neurologic symptoms at end of life.

Interpersonal Communication

Goals

Gain proficiency leading family and multidisciplinary discussions regarding the care of patients with life limiting diagnoses.

Objectives

Interface with providers in other subspecialties both in the outpatient and inpatient setting to arrive at a treatment path for patients at end of life.

Practice-Based Learning and Improvement 

Goals

Identify opportunities for improvement in the delivery and quality of patient care for those with complex medical needs.

Objectives

Review learning and improvement goals through frequent feedback from staff physicians working with them.  Incorporate all available learning sources, including information technology to optimize their learning of all aspects of palliative care.

Reflect on difficult patient or family interactions and identify methods to improve communication in those scenarios.

Professionalism

Goals

Residents will demonstrate ongoing self-education and habits of life-long learning.

Objectives

Residents will maintain the highest standards of professionalism, especially in interactions with patients and palliative care clinic faculty and staff.  The resident will be responsible for tracking duty hours and reporting them to the supervisory attending.

Systems-Based Practice

Goals

Residents will recognize that they are part of a multidisciplinary team and the complexity required to coordinate care across multiple subspecialties for those patients at end of life.

Objectives

Describe the roles of interdisciplinary team members on the palliative care service including, but not limited to attendings, APPs, social work, child life, chaplains, and case management.

Objectives and Evaluation Matrix

As with all of the neurology rotations, the specific objectives are reflected in the entrustable professional activities and individual milestones listed below. These form the basis for the end-of-rotation evaluation.

Objectives and Evaluation Matrix

09/09/2026  Adam Wallace, MD