title: Developing a pediatric palliative care service in a large urban hospital: challenges, lessons, and successes.
abstract: OBJECTIVE
  We report the process of creating a new palliative care service at a large, urban children's hospital. Our aim was to provide a detailed guide to developing an inpatient consultation service, along with reporting on the challenges, lessons, and evaluation.
  
  
  METHODS
  We examined the hiring process of personnel and marketing strategies, a clinical database facilitated ongoing quality review and identified trends, and a survey project assessed provider satisfaction and how referring physicians used the palliative care service.
  
  
  CONCLUSIONS
  The pilot phase of service delivery laid the groundwork for a more effective service by creating documentation templates and identifying relevant data to track growth and outcomes. It also allowed time to establish a clear delineation of team members and distinction of roles. The survey of referring physicians proved a useful evaluation starting point, but conclusions could not be generalized because of the low response rate. It may be necessary to reconsider the survey technique and to expand the sample to include patients and families. Future research is needed to measure the financial benefits of a well-staffed inpatient pediatric palliative care service.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, CA 90027, USA. eedlynn@hotmail.com
authors.forename: Emily S
authors.initials: ES
authors.lastname: Edlynn
authors.forename: Sabrina
authors.initials: S
authors.lastname: Derrington
authors.forename: Helene
authors.initials: H
authors.lastname: Morgan
authors.forename: Jennifer
authors.initials: J
authors.lastname: Murray
authors.forename: Beatriz
authors.initials: B
authors.lastname: Ornelas
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cucchiaro
mesh_terms: D003625:Data Collection; D016208:Databases, Factual; D006776:Hospitals, Pediatric; D006786:Hospitals, Urban; D006801:Humans; D040541:Marketing; D008389:Marketing of Health Services; D020380:Needs Assessment; D009722:Nurse Practitioners; D010166:Palliative Care / Q000458:organization & administration*; D010560:Personnel Selection; D016730:Program Development