Pediatric palliative care in the community.

Area of Science:

• Pediatrics
• Palliative Care
• Healthcare Management

Background:

• Pediatric palliative care (PPC) offers holistic support for children with life-threatening conditions and their families, addressing physical, psychological, social, and spiritual needs.
• PPC aims to improve care continuity throughout the illness trajectory, without impeding curative treatments.
• Community-based pediatric palliative care (CBPPC) is emerging as a crucial component for coordinating and delivering quality care outside traditional hospital settings.

Purpose of the Study:

• To examine the purpose, design, and infrastructure of CBPPC programs in the United States.
• To highlight eligibility criteria, optimal referral models for early involvement, and fundamental tenets of CBPPC.
• To appraise the role of CBPPC in promoting family-centered care, shared decision-making, and seamless care transitions.

Main Methods:

• This review synthesizes information on CBPPC programs in the U.S.
• It examines program design, infrastructure, eligibility, referral models, and family-centered care principles.
• The review also discusses legislative impacts, current program status, implementation barriers, and strategies for quality improvement.

Main Results:

• CBPPC programs are integral to enhancing care coordination, continuity, and family-centered care for children with life-threatening conditions.
• These programs facilitate shared decision-making, maintain desired care locations, and support end-of-life care at home.
• Legislation has influenced the evolution of CBPPC, though barriers to implementation persist.

Conclusions:

• Community-based pediatric palliative care is essential for comprehensive, family-centered support throughout a child's illness.
• Effective CBPPC models require strategic design, implementation, and ongoing quality management.
• Addressing barriers and leveraging legislative support are key to expanding access to quality CBPPC.