Pediatric Advanced Care Team (PACT)

The Pediatric Advanced Care Team (PACT) is a team of interdisciplinary clinicians with expertise in pediatric palliative care.  PACT provides an extra layer of support for children – from before birth through young adulthood -- and their families diagnosed with a complex or serious illness.  Many serious medical conditions can shorten the expected lifespan of children. This can cause emotional stress and leave parents in a state of uncertainty about their child’s future and prognosis. In such cases, it’s important to identify ways to help children and their families have the best quality of life possible. 

Palliative care is often misunderstood.  People frequently associate palliative care with end-of-life (hospice) care or “giving up.”  In reality, palliative care together with curative treatment is appropriate for any stage of illness.  PACT offers an additional layer of support by specialists to provide relief from the symptoms, pain and psycho-social, emotional and spiritual stress of serious illness for both the patient and the family. 

Palliative care is a family-centered approach to care that:

• Supports decision-making
• Provides interventions to minimize symptoms causing discomfort and pain
• Facilitates care in the hospital 
• Helps families communicate with healthcare providers, aiding families in making informed choices about difficult medical decisions.
• Relieves stress that often accompanies a serious illness
• Aids with transitions to home 

We focus on matching medical treatment with the goals of your child and family.  In partnership with curative treatment, we support your child’s and family’s psychological, social and spiritual needs. 

The PACT Team

PACT includes physicians, nurse practitioners and a social worker who work in collaboration with spiritual care, and other pediatric specialists to help both the child and family deal with feelings, symptoms, and concerns during a time that may be frightening, confusing and overwhelming.

Services Provided 

When your child is facing a serious illness, you may feel your life has been turned upside down. PACT customizes care to meet the needs of each individual patient and family. We provide families with:

• Decision making assistance:   help families consider the choices that may be needed in the future.  Discuss the “pros” and “cons” of medical interventions you might consider, and help you consider the decisions that best honor your family’s values and preferences.  PACT will offer support as you consider how an intervention will affect your child's life and whether or not the intervention will enhance how your child lives.
• Communication guidance: help you and your child communicate with your healthcare team, family members and your child’s siblings.
• Supportive care:  provide a caring presence throughout your child’s care and treatment. 
  • Hope:  We promote the continuance of hope.  
  • Emotional support: Families often struggle with feelings of guilt, anger, powerlessness, frustration and grief during times of illness, uncertainty, transition and loss.  PACT offers emotional support in a safe setting.
  • Spirituality support: explore the meaning of what is happening as you face the challenges of serious illness
• Symptom management:  improve symptoms that cause discomfort.
• Continuity:  PACT gets to know you, your family and your child.  We are a constant as you continue your child’s journey and multiple hospital admissions. For those families living in the St. Louis area, PACT strives to provide an umbrella of care and will work closely with BJC Wings, a home-based pediatric program serving children and families while they cope with acute, chronic or terminal illness.  
• Caring for caregivers:  Caring for a child with a serious illness can be challenging, stressful and exhausting.  We help parents find some normalcy in the midst of caring for a child with complex needs and stress the importance of self-care so you can be the best parent possible.
• Transition to hospice if needed:  Palliative care is not hospice care. We join families in hoping for the best.  If faced with end of life issues, however, PACT encourages open and honest discussions about difficult subjects like dying and death. We discuss what may come, and if and when hospice is appropriate.  PACT helps provide seamless transition to hospice in the St. Louis or through BJC Wings.  PACT also helps support hospices outside the St. Louis area, to assist the care of children in their home community. 

Fellowship Opportunities

The Department of Pediatrics at Washington University School of Medicine offers an ACGME accredited one-year clinical fellowship in Hospice and Palliative Medicine, as the pediatric track.  Learn more.