Bridging the Gap: Expanding General Inpatient Transitions to the Pediatric Population

Key Message: Hospitals continue to strive towards reductions in mortality index as a measure of quality care. The transition of pediatrics patients to General Inpatient level of care under hospice services can serve to both manage complex symptoms and promote comfort, dignity, and family-centric care, including bereavement services, at end of life.

Abstract: Transitioning pediatric patients from curative treatment to hospice care present unique challenges, especially in acute care hospitals. Prognosis and subsequent goals of care may rapidly shift. Multiple teams are often involved in pediatric serious illness with differing opinions and messages to families. With a concurrent care model for hospice care and life prolonging treatments, providers and families may have increased confusion over goals of care between hospitals and hospice agencies. Many hospice agencies do not expand into consistent pediatric services as well. While adult pathways are clearer and more established, pediatric transitions to General Inpatient (GIP) hospice care remain underdeveloped and inconsistently implemented.
This presentation will examine effective practices and protocols, barriers, and key considerations in transitioning hospitalized pediatric patients to hospice GIP care, and propose a model that supports compassionate and goal-concordant care. It will highlight critical factors for successful GIP transitions, including early palliative involvement, standardized eligibility criteria for GIP admission, family-centered communication and partnerships between inter-professional hospital and hospice teams. The overall goal of such transitions is to support hospitals in providing quality of end of life care for pediatric patients, reduce inpatient mortality in the pediatric population, and ensure that pediatric patients and their families receive appropriate symptom management, psychosocial and spiritual support at end of life.

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