Children without underlying diagnoses in their records who may have received previous hospital care at MHUMC for short febrile illnesses, isolated incidents of asthma, or minor accidents were considered previously healthy children.
The care needs of dying children at MHUMC rarely follow a single path, which starts with curative or palliative care and progresses through a series of defined stages.
With an estimated 90% of the childhood deaths studied initially seen or cared for exclusively in the MHUMC emergency department, for MHUMC and many small hospitals like ours, the emergency department can be considered the primary point of entry for the children who die.
With 78% of the study group dying within 24 hours of admission, the MHUMC pediatric end-of-life care staff will need to be available on extremely short notice 24 hours a day.
Using these as guides, the documentation system that works best for MHUMC patients and their families will be tested and developed.
The numbers and proportions of children in each of the four dying trajectories in this study apply to BCH and MHUMC alone.
Understanding the HDTs at MHUMC has helped define where care should begin and what gaps in education, documentation, and services must be filled and helped to clarify and manage the seemingly unrelated, diverse ways that children die.