Compassionate Care for Grieving Families
Sometimes, despite the best that medicine has to offer, we can't prevent a child's death. Last year, more than 230 patients at Cincinnati Children's Hospital Medical Center died.
"We can't change the outcome of the death, but we know we can do a better job of helping parents at this most horrific time in their lives," says Jan Borgman, bereavement coordinator.
As chair of the End of Life Committee, Borgman leads a team of hospital staff and parent volunteers who come together monthly to focus on how the hospital can better meet the needs of bereaved families. The parents on the committee all have lost children. "They are on the committee because they have walked that path and they want to help others," Borgman says.
Brenda Harkleroad and Michelle Spillane have served on the End of Life Committee for three years. Brenda's daughter, Abbie, was diagnosed with leukemia when she was 2 and died four years later. Michelle's son, Garrett, was 14 when he died of a brain tumor.
"I'd seen death before," Michelle says. "I've lost a parent. As a nurse I've seen patients die. But never did I imagine the emotions I would feel at the death of my child. As a parent who has lost a child, you have a different insight. You're able to talk from your heart."
A Sensitive Approach to Billing
With input from its parent members, one of the major issues the End of Life Committee tackled was billing for bereaved families.
"The day we came home from the funeral, there was a bill from the hospital," Brenda recalls. "On the one-year anniversary of Abbie's death, we were still dealing with bills. We got a phone call that day about a bill and my husband burst into tears."
As the parents on the End of Life Committee shared their experiences, they told similar stories about the pain and frustration of dealing with bills immediately after the death of their child. "When you're going through this," Brenda points out, "you don't look at it from the hospital's point of view. All you see is the insensitivity."
Based on their input, parents and staff on the End of Life Committee chose this issue for a major initiative. They found a willing partner in the Billing Department. This productive partnership led to a new policy: When a child dies, the hospital and its physicians suspend sending all billing statements.
All billing issues for bereaved families now are handled by one billing specialist. Forty-five days after the death, she sends a letter introducing herself as the family's personal link to the Billing Department. The letter explains that she is working behind the scenes with the family's insurance company to resolve all billing issues.
It took almost a year to develop a reliable system for capturing information about every death. Computer links helped. Now the billing system is automatically flagged via a new link to the clinical information system. For deaths that occur outside the hospital, social workers and other staff who have close interaction with families are important links in the notification system.
Today, the electronic flagging system that initiates the bereavement billing process also alerts the Call Center to cancel any scheduled appointments and suspend the mailing of appointment reminders.
Easing the Pain
For Brenda and Michelle, the success of the bereavement billing project has been very gratifying. "It was a huge undertaking to coordinate this, and I'm amazed at how willing the departments were to address the issue and work together," Brenda says.
"Knowing I'm making things better for someone else after a child dies was good for me," says Michelle. "It was healing."
