• Pediatric Advanced Care Team (PACT) - Palliative Care Program

    The Pediatric Advanced Care Team (PACT), our nationally-recognized palliative care service, provides an extra layer of support — healing, comfort and quality of life — to the care of children with serious illness and their families.

    The Pediatric Advanced Care Team consults with families and primary care teams to bring together information and guidance needed to make the best health care decisions for each child.

    Our services include: 

    • Easing pain and managing symptoms and side effects
    • Fostering communication between families and health care providers
    • Coordinating inpatient, outpatient, and homecare services

    We include experts from a wide variety of disciplines to care for your child. Our care team includes: 

    • Physicians with advanced training in palliative care
    • A nurse practitioner with extensive experience providing pediatric palliative care
    • A social worker with expertise in emotional support and community resources
    • Dedicated spiritual care services
    • Other pediatric specialists as needed

    We consider you and your child to be integral parts of the care team and not simply recipients of care. We work closely with you to customize a plan of care for your child.

    Our Services

    The PACT has served as a model program for pediatric institutions around the United States. Joanne Wolfe, MD, MPH, our Division Chief and medical director, is nationally recognized for her pediatric palliative care expertise.

    Wolfe and other members of the team participate in regional and national efforts to improve care for children with advanced illness.

    The PACT's services include:

    Consultation

    PACT members will work closely with your child, family, and primary care team to develop a comprehensive quality-of-life care plan. We do not replace your child's primary care team; rather, we support treatment of the illness and at the same time strive for optimal quality of life.

    During your consultation, we will evaluate factors such as your child's feelings and health, your family's needs, and the care team's medical plan in order to make the best possible recommendations. Our clinicians can meet with your child and family at the hospital, at one of our outpatient facilities, or at your home.

    Education

    Our team members want your child and family to make educated decisions. We are available to talk with you and provide educational resources on a variety of topics, including communication and decision-making, pain and symptom management, palliative care, hospice and home care, family dynamics, sibling issues, school interactions, and spiritual concerns.

    Support

    It's important that your child and family have support both at the hospital and when you return home. We can help identify supportive agencies and community-based organizations. In addition, we can provide emotional and psychosocial support, and help arrange end-of-life care when necessary.

    A consultation can be arranged at any time during your child's treatment. Our team is available to provide consultation 24 hours a day.

    The Care Team

    Our staff of compassionate and experienced pediatric specialists includes clinicians and other healthcare providers with expertise in palliative care, symptom management, complementary medicine, and interfaith spiritual care.

    Our clinicians are focused on family-centered care. From your first visit, you'll work with a team of professionals who are committed to supporting your family's physical and emotional needs.

    Joanne Wolfe, MD, MPH, Division Chief and Medical Director
    Joanne Wolfe is Division Chief of Pediatric Palliative Care at the Dana-Farber Cancer Institute (DFCI) and Director of Palliative Care at Boston Children’s Hospital (BCH). She is the BCH Harvard Palliative Medicine site director and is an Associate Professor at Harvard Medical School. She is board certified in Hospice and Palliative Medicine and Pediatric Hematology/Oncology. Dr. Wolfe is nationally recognized for her pediatric palliative care expertise and received the 2013 American Cancer Society Pathfinder in Palliative Care Award. Her research focuses on improving care for children with advanced illness.

    Richard Goldstein, MD
    Rick Goldstein is a PACT Attending Physician and an Assistant Professor in Pediatrics at Harvard Medical School. He is a general pediatrician with expertise in palliative care, behavioral-developmental pediatrics and community-based medicine. He is a senior physician at Dana-Farber Cancer Institute, and he oversees the pediatric palliative care curriculum for fellows and residents. His research focuses on sudden, unexpected loss and parental grief.

    Emma Jones, MD
    Emma Jones is a PACT Attending Physician and Instructor in Pediatrics at Harvard Medical School. She is board certified in Hospice and Palliative Medicine, Pediatric Hematology/Oncology and Clinical Pharmacology. Areas of interest include acute and chronic pain management in sickle cell disease, comprehensive assessment of pain, and patient and caregiver education.

    Christina Ullrich, MD, MPH
    Christina Ullrich is a PACT Attending Physician and Assistant Professor in Pediatrics at Harvard Medical School. She completed fellowships in Pediatric Hematology/Oncology and Pediatric Palliative Care at Dana-Farber/Boston Children's and is board certified in Hospice and Palliative Medicine and Pediatric Hematology/Oncology. Her research interests include symptom management in children with cancer, with a focus on fatigue. She is also currently investigating the palliative care needs of children who undergo hematopoietic stem cell transplantation.

    Janet Duncan, RN, MSN, CPNP
    Janet Duncan is the founding nurse practitioner for PACT with expertise in pediatric palliative care and hematology/oncology. She focuses on outpatient care and pediatric palliative care education and training.

    Rachael Menius, MSN, CPNP-AC, CPON
    Rachael Menius is an acute care pediatric nurse practitioner for the Pediatric Advanced Care Team on the inpatient and outpatient services.

    Marsha Joselow, LICSW, MSW
    Marsha Joselow is a clinical social worker for PACT and also the Pediatric Palliative Care Social Work Fellowship Director. She follows patients both inpatient and outpatient and coordinates the PACT bereavement care.

    Christopher Collura, MD (Pediatric Palliative Care MD Fellow)
    Chris Collura completed medical school at Saint Louis University. He trained in Pediatrics and Neonatal & Perinatal Medicine at Mayo Clinic and is a master’s degree candidate in Bioethics from the University of Minnesota. Following his fellowship with PACT, he will join the Department of Pediatric & Adolescent Medicine at Mayo Clinic as a staff neonatologist and pediatric palliative medicine physician. He is interested in pediatric health care disparities in palliative care and perinatal and pediatric bioethics.

    Kevin Madden, MD (Pediatric Palliative Care MD Fellow)
    Kevin Madden graduated from UMDNJ-New Jersey Medical School in 2000. He completed his residency in General Pediatrics and fellowship in Pediatric Critical Care Medicine at Children's Hospital Los Angeles. He has been an attending physician at both Children's Hospital Los Angeles and City of Hope National Medical Center since completing his fellowship in 2010. His academic interests include mindfulness meditation for management of anxiety and depression.

    Arielle Eagan, LICSW (Pediatric Palliative Care Social Work Fellow)
    Arielle Eagan received her Master of Social Work from Boston College, with an individualized, combined concentration in health and children, youth and families. In her most recent position as an Oncology Clinical Social Worker with the Dana-Farber/Brigham and Women’s Cancer Center, Eagan provided clinical support for patients and families facing life-threatening illness. 

    Rita Fountain
    Rita Fountain is the Practice Coordinator for the PACT.

    Contact Us

    Our team is available by page 24 hours a day.

    To call the Dana-Farber page operator, dial 1-617-632-3352 and ask for the clinician by name or the PACT clinician on call.

    To call the Boston Children's Hospital page operator, dial 1- 617-355-6000 and ask for the clinician by name.

    For non-urgent matters Monday-Friday, please call 1-617-632-5042 during regular business hours or email Rita Fountain at rita_fountain@dfci.harvard.edu. If you are unable to reach us at this number or through email, please use the paging instructions above.

    Mailing address 

    Pediatric Advanced Care Team

    Dana-Farber Cancer Institute

    450 Brookline Avenue, SW 411

    Boston, MA 02215

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