BackgroundAround the world, different models of paediatric palliative care have responded to the unique needs of children with life shortening conditions. However, research confirming their utility and impact is still lacking. This study compared patient-related outcomes and healthcare expenditures between those who received home-based paediatric palliative care and standard care. The quality of life and caregiver burden for patients receiving home-based paediatric palliative care were also tracked over the first year of enrolment to evaluate the service’s longitudinal impact.MethodA structured impact and cost evaluation of Singapore-based HCA Hospice Care’s Star PALS (Paediatric Advance Life Support) programme was conducted over a three-year period, employing both retrospective and prospective designs with two patient groups.ResultsCompared to the control group (n = 67), patients receiving home-based paediatric palliative care (n = 71) spent more time at home than in hospital in the last year of life by 52 days (OR = 52.30, 95% CI: 25.44–79.17) with at least two fewer hospital admissions (OR = 2.46, 95% CI: 0.43–4.48); and were five times more likely to have an advance care plan formulated (OR = 5.51, 95% CI: 1.55–19.67). Medical costs incurred by this group were also considerably lower (by up to 87%). Moreover, both patients’ quality of life (in terms of pain and emotion), and caregiver burden showed improvement within the first year of enrolment into the programme.DiscussionOur findings suggest that home-based paediatric palliative care brings improved resource utilization and cost-savings for both patients and healthcare providers. More importantly, the lives of patients and their caregivers have improved, with terminally ill children and their caregivers being able to spend more quality time at home at the final stretch of the disease.ConclusionsThe benefits of a community paediatric palliative care programme have been validated. Study findings can become key drivers when engaging service commissioners or even policy makers in appropriate settings.

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Background Individuals with serious illness face complex healthcare decisions which have important and lasting consequences. Person-centered care can be achieved when personal values, goals, and beliefs are aligned with the actual care provided.Person-centered decision-making requires a) clear, accurate and unbiased information about all options, including risks versus benefits; b) clinician investment and expertise in engaging and communicating with patients; and c) the effective integration of personal values, goals, and beliefs into choices. Person-centered decision aids (PDAs) are tools designed to help patients and providers in the process of shared decisionmaking. Research shows, high quality PDAs lead to increased knowledge, more accurate risk perception, reduced indecision about care, and improved patient engagement. Methods Based on criteria developed by the International Patient Decision Aids Standards Collaboration (IPDAS), Healthier Washington Initiative, Washington State, USA, developed and implemented a process of certifying PDAs to assure they are effective, accurate, unbiased tools to use in the shared decision-making process. Implementation of quality PDAs can be standardized using the fundamentals described in the National Quality Forum's(NQF) National Quality Partners (NQP) Playbook-Shared Decision-Making in HealthCare. Results This presentation will review certification criteria for developing high-quality PDAs. A four-phased approach will be discussed that describes the process of developing and certifying three serious illness decision aids and their integration within Respecting Choices ® person-centered decision-making programs. Conclusion Development and certification of quality PDAs in healthcare organizations using a standard approach to the decision-making process can support a culture of person-centered care.

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