Models of Pediatric Palliative Oncology Outpatient Care-Benefits, Challenges, and Opportunities

Area of Science:

• Pediatric Oncology
• Palliative Care
• Healthcare Delivery Models

Background:

• Pediatric palliative care (PPC) services are predominantly in inpatient settings, yet most clinical care occurs outpatient.
• Integrated PPC and pediatric oncology is becoming standard, necessitating novel outpatient pediatric palliative oncology (PPO) models.
• The optimal PPO outpatient model is undetermined and institution-dependent.

Purpose of the Study:

• To review five distinct outpatient PPO clinical models from different institutions.
• To identify the benefits and challenges associated with each PPO model.
• To provide practical guidance for PPO clinic development, implementation, and resource allocation.

Main Methods:

• A review of five unique outpatient pediatric palliative oncology clinical models.
• Analysis of the benefits and challenges inherent in each model.
• Identification of pragmatic guidance for clinic development and resource management.

Main Results:

• Examined models include floating clinics, embedded disease-specific PPC experts, consultative/trigger-based supportive care clinics, and telehealth.
• Highlighted organizational successes in overcoming personnel, funding, and logistical hurdles.
• Demonstrated variability in PPO models based on institutional factors.

Conclusions:

• No single PPO model fits all; institutions should tailor models to their resources and needs.
• Successful PPO clinics require balancing unique organizational challenges and opportunities.
• The ultimate goal is to provide high-quality PPC for children with cancer and their families.