Rakhshanda Ramzan, Lisa C Lindley, Logan Hoover, Jia Liang, Markeya Martin, Salina Temesghen, Meaghann S Weaver
A brief virtual workshop shifted hospice workforce perceptions of pediatric concurrent care, revealing gaps in baseline understanding and increasing awareness of implementation challenges. Findings informed development of a Pediatric Concurrent Care Toolkit and suggest that practical implementation resources, policy guidance, and family-centered communication tools may be needed to improve uptake and access to concurrent care.
CONTEXT: Medicaid insures most children at the end of life and mandates concurrent hospice and curative care coverage. Uptake remains inconsistent, partly due to hospice workforce unfamiliarity with the benefit and concerns about compliance.
OBJECTIVES: To evaluate whether a brief virtual workshop can shift hospice workforce self-perceived knowledge, attitudes, and behavior (KAB) regarding pediatric concurrent care, and to identify workforce-informed priorities for a Concurrent Care Toolkit.
METHODS: Two national one-hour virtual workshops (clinical and administrative audiences) were conducted in April 2026 (n=264 attendees). A 7-item retrospective pre/post KAB survey was distributed post-session. McNemar's and Fisher's exact tests assessed changes and subgroup differences. Real-time chat input was analyzed to identify desired toolkit content.
RESULTS: Thirty respondents completed the survey (11.4%). Perceived ability to contribute effectively increased (from 76.7% to 86.7%) and was higher among respondents from frequently enrolling hospices (100% vs. 62.5%, p=0.0205). Scores significantly decreased pre- to post survey across five of seven KAB items: understanding, resource awareness, perceived value, outcome improvement, and adaptability (p<0.05). Confidence explaining concurrent care to families declined nonsignificantly (from 86.7% to 63.3%). Attendee toolkit suggestions (n=26) emphasized needs in policy guidance, role clarity, best practices, and templates, including family-facing materials.
CONCLUSION: A brief virtual workshop shifted hospice workforce perceptions of pediatric concurrent care, revealing gaps in baseline understanding and increasing awareness of implementation challenges. Findings informed development of a Pediatric Concurrent Care Toolkit and suggest that practical implementation resources, policy guidance, and family-centered communication tools may be needed to improve uptake and access to concurrent care.