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Grand Rounds: Palliative Care: Going ‘Outside the Box’ to Improve Patient Care and Experience In and Out of the Hospital


By Kate Cicozi, MD, and Seon Lee, MD , Palliative Care Fellows, Akron Children's Hospital, Akron, OH

Palliative Care

Objectives (Educational Content) :

1. Describe two ways in which bibliotherapy can help improve inpatient experience. 2. Identify the benefits of palliative care home visits and the role they serve in a medical home model of care for patients with complex chronic conditions. 3. Describe non-traditional methods of support offered to families through palliative care team involvement for children with life-threatening conditions.

Target Audience:

General pediatricians, family physicians, nurse practitioners, physician assistants, social workers, psychologists and nurses

Identified Gap:

Enhancements in palliative care for pediatric patients with chronic medical conditions will improve health outcomes for these patients.

Estimated Time to Complete the Educational Activity:

1 hour

Expiration Date for CME Credit:


Method of Physician Participation in the Learning Process:

The learner will view the presentation, successfully complete a post-test and complete an activity evaluation.

Evaluation Methods:

All learners must successfully complete a post-test, as well as an activity evaluation, to claim CME credit.


Drs. Cicozi and Lee have indicated that they have no relevant financial interest in any pharmaceutical or medical device company and that this activity was developed independent of commercial interest.

Accreditation Statement:

Children’s Hospital Medical Center of Akron is accredited by the Ohio State Medical Association to provide continuing medical education for physicians.

CHMCA designates this enduring material activity for a maximum of 125 AMA PRA Category 1 Credit TM.  Physicians should only claim the credit commensurate with the extent of their participation in the activity.


Montgomery, P., & Maunders, K. (2015). The effectiveness of creative biblioherapy for internalizing, externalizing and prosocial behaviors in children: A systematic review. Children and youth services review, 55, 7-47.

Goddard, A. T. (2011). Children’s books for use in bibliotherapy. Journal of Pediatric Health Care, 25(1), 57-61.

Goldhagen, J., Fafard, M., Komatz, K., Eason, T., & Livingood, W.C. (2016). Community-based pediatric palliative care for health-related quality of life, hospital utilization and cost lessons learned from a pilot study.  BMC Palliative Care, 15(1).