Pediatric hospital dying trajectories: what we learned and can share

Area of Science:

• Pediatrics
• Palliative Care
• Healthcare Management

Background:

• Small hospitals face challenges in providing comprehensive end-of-life care for pediatric patients due to diverse settings and diagnoses.
• Limited time and resources impact the quality of palliative and end-of-life care for children in regional hospitals.

Purpose of the Study:

• To document the circumstances surrounding the deaths of children at a regional hospital in southeast Georgia.
• To assess the palliative and end-of-life care provided to these pediatric patients.
• To define hospital dying trajectories to inform care program planning.

Main Methods:

• Retrospective study of children who died at a regional hospital.
• Data collection on causes of death, care setting at time of death, and hospitalization duration.
• Categorization of patients into four hospital dying trajectories based on medical history and hospitalization length.

Main Results:

• Common causes of death included injury and circulatory events.
• 56% of children were in the Emergency Department at death; 72% were previously healthy.
• 78% of children were hospitalized for less than 24 hours before death.

Conclusions:

• Four distinct hospital dying trajectories were identified, offering insights into pediatric end-of-life care needs.
• These trajectories can guide the development of targeted pediatric palliative and end-of-life care programs.
• Understanding trajectories helps identify critical settings, time constraints, and necessary personnel for comprehensive care.