‘The expectation that we can be immersed in suffering and loss daily, and not be touched by it, is as unrealistic as expecting to be able to walk through water without getting wet.’ Dr Rachel Naomi Remen, Kitchen Table Wisdom: Stories that Heal

Clinicians supporting children with life limiting conditions (LLC), and their families, often report the work as being highly rewarding. However, the wellbeing of palliative care clinicians may also be affected.  Facing and making difficult decisions, bearing witness to the anguish of families’ suffering and the death of young people, potentially without adequate preparation or support, can impact clinician’s capacity and capability. 

The PPC ECHO community of practice was piloted in 2020 at Children’s Health Queensland and continues each month to present day. Project ECHO developed in 2003, by the University of New Mexico, aimed to build capacity and increase access to specialist-level care in underserved populations. 
By using, a non-hierarchical learning model, via de-identified case discussions, participants report many benefits, as well as enhanced outcomes in the care provided to young people with LLC and their families.

In 2021, the PPC ECHO community of practice, aimed to gain a better understanding of case presenters’ experiences and the network’s impact. 
A mixed methods approach was undertaken.  Surveys and a focus group enabled feedback about participants’ experience of presenting de-identified cases. Presenter’s perspectives on what their expectations were; barriers and motivators for joining the network; and any impacts were elicited. 
 Demographic data was collected, and informal thematic analysis was undertaken.

5 out of 7 case presenters participating in the focus group, were working cross- sector and inter-state and reflected the inter-professional composition of the network.  
Five themes arose from the preliminary findings of the case presentation experience namely: 
1. Connecting and networking 
2. Supportive environment 
3. Up-skilling 
4. Reflective practice 
5. Well-being

In the everchanging context of COVID-19, played out against a backdrop of global events and recent natural disasters, we assert that the CHO community of practice that evolved from the PPC ECHO network was and continues to be responsive to clinicians, as well as patient, needs.