Regional Pediatric Education and Assistance Collaborative for Hospice Nurses (REACH): A Tele-Educational Intervention.

Despite the well-known benefits of hospice care for seriously ill children and their families, pediatric hospice services remain difficult to access across community settings. The vast majority of hospice organizations utilize an adult-focused paradigm, in which adult-trained providers often lack the requisite pediatric-specific education to provide high-quality hospice care for children and families. Hospice nurses self-report significant discomfort with pediatric care provision, resulting in hesitation by hospice agencies to accept pediatric patients, further exacerbating deficits in pediatric hospice access across the nation. Given the growing numbers of children with serious illness eligible for hospice in the community, innovative strategies are urgently needed. To address this gap, a multidisciplinary team comprising physicians, nurses, psychosocial clinicians, community members, and bereaved parents was convened to develop the Regional Pediatric Education and Assistance Collaborative for Hospice Nurses (REACH) initiative. Using a community-based participatory research approach, a stakeholder-driven tele-educational intervention was designed, refined, and implemented as a pilot for hospice nurses across Tennessee. Pilot data showed this hub-and-spoke model to be feasible, acceptable, and impactful, increasing hospice nurses' knowledge and comfort with provision of pediatric care in the community. Future work will focus on the expansion of REACH across Louisiana, followed by other states.