The goal of Pediatric Palliative and Complex Care is to improve the quality of care for children with serious illnesses and their families. Pediatric and Complex Care houses several programs to work with families based on their needs, these programs include:
Pediatric Enhanced Care Program
The Pediatric Enhanced Care Program (PECP) provides complex care and palliative care to children with complex medical conditions receiving care at Brenner Children’s. These children often have multiple health care providers involved in their care, are dependent on medical technology to live, and are frequently hospitalized.
PECP was started in 2008 with funding from the Duke Endowment. PECP helps children and families with symptom management, medical decision-making, discussion of goals of care, and emotional support. We coordinate care and guide families as children transition from hospital to home. We serve children by enhancing communication between health care providers and caregivers, and by providing continuity of care across hospitalizations.
The community component of PECP, called the Community-based Pediatric Enhanced Care Program (CPECT), was started in 2009 with funding from the Health Resources & Services Administration. This program leverages the strong collaborative relationships that exist among agencies serving children with complex conditions in our community. We work with primary care physicians and offer care coordination services and emotional support to children with complex medical conditions and their families. PECP team is interdisciplinary: Dr. Nageswaran and Dr. Sebesta are the physicians, Ms. Radulovic, Ms. Skaar, and Ms. Ennis are the nurse coordinators, Ms. Rosado is the social worker, and Ms. Ortiz is the patient navigator.
Declan Donoghue Collaborative Care Program
The Declan Donoghue Collaborative Care Program (DDCCP), started in 2011, is an innovative program at Brenner Children’s designed to reduce mortality and morbidity in children who have undiagnosed complex conditions, or complex medical conditions with an unresolved clinical problem. This is achieved by a comprehensive approach of bringing together primary care physicians and multiple subspecialists to share information and ideas for evaluation and treatment. This program was developed to honor the life of Declan Donoghue and to bring attention to the difficulty of diagnosing unexplained medical ailments. Dr. Nageswaran is the physician and Ms. Ennis is the nurse coordinator of DDCCP.
Learn about the Declan Donoghue Foundation.
Care Always Perinatal/Neonatal Palliative Care Program
Care Always is a program developed in 2016, in collaboration with Maternal-Fetal Medicine and Neonatology, for families that have a fetus or baby who is diagnosed in-utero or after delivery with life-limiting conditions, multiple congenital anomalies, and extreme prematurity (22-23 weeks gestation).
The program provides care that focuses on quality of life for infants with complex medical conditions and end-of-life care for dying infants and their families. The program offers advanced care planning for families before the birth of the baby and supports families through their child's journey in the NICU. Jennifer Holman, MD, a neonatologist is the director of Care Always and the physician of the program, and Shannon Hanson, PhD, is the family behavioral specialist of Care Always.
Pediatric Oncology Palliative Care Program
The Pediatric Oncology Palliative Care Program is a new initiative created in 2020 that provides an additional support to children with cancer and their and families. This is a multidisciplinary service that strives to improve the quality of life of children by effectively managing their symptoms, and reducing psychological stressors, and by supporting families by identifying resources and guiding in decision-making.
Our team works very closely with the pediatric hematology/oncology providers to ensure children and their families receive a holistic approach to their cancer therapy. Dr. Leila DeWitt and Ms. Kat Pearsall are the providers, and Ms. Jodi Pardue is the social worker of the Pediatric Oncology Palliative Care Program.
Because We Care Program
The Because We Care (BWC) program was started in 1992 by a pediatric nurse after the loss of her son. The program was initially created to offer written bereavement support to families following the loss of their child. Over the years the program has grown to include memory-making by creating keepsakes such as hand or footprints and impressions, and pictures. BWC offers ongoing support to bereaved families and holds and an annual event celebrating the lives of children who have died. With the opening of the Winston-Salem campus Birth Center in 2019, BWC expanded its services to include support for families across the pregnancy continuum. To date the Because We Care program has offered bereavement support to over 3,000 families in this region who have received care within the Wake Forest Baptist Health system. Ms. Angel Mitchell is the program manager of BWC.