Implementing the PAR Scale in a Pediatric Concurrent Care Setting: A Quality Improvement Project

Pediatric patients in concurrent hospice and palliative care often face fragmented communication regarding family goals of care during acute hospitalizations. This quality improvement project evaluated clinician and care coordinator experiences with the implementation of the Preference for Acute Rehospitalization Scale at Children’s Nebraska. A pre- and postimplementation survey design (n = 41 pre-implementation; n = 35 postimplementation) assessed awareness of family goals, confidence in decision-making, and perceptions of the tool among an interdisciplinary team. While clinicians expressed general openness to standardized communication tools, results showed no statistically significant differences in survey items, highlighting that successful adoption in complex pediatric settings requires sustained education, seamless workflow integration, and robust interdisciplinary engagement to ensure treatment remains aligned with family preferences.