• Ashley K Autrey, Casie James, Sarvode MothiSurajSDepartment of Biostatistics, St. Jude Children's Research Hospital (S.S.), Memphis, Tennessee, USA., Caroline Stafford, Alexis Morvant, Elissa G Miller, and Erica C Kaye.
• Pediatric Palliative Care Service Line, Children's Hospital New Orleans (A.K.A., A.M.), New Orleans, Louisiana, USA; Department of Pediatrics, Louisiana State University Health Sciences Center (A.K.A., C.S., A.M.), New Orleans, Louisiana, USA; Department of Pediatrics, Tulane University School of Medicine (A.K.A., A.M.), New Orleans, Louisiana, USA. Electronic address: ashley.autrey@lcmchealth.org.
• J Pain Symptom Manage. 2023 Jul 1; 66 (1): 1231-23.

ContextInpatient pediatric palliative care (PPC) has grown substantially over the past 20 years; however, PPC in the outpatient setting remains underdeveloped. Outpatient PPC (OPPC) offers opportunities to improve access to PPC as well as facilitate care coordination and transitions for children with serious illness.ObjectivesThis study aimed to characterize the national status of OPPC programmatic development and operationalization in the United States.MethodsUtilizing a national report, freestanding children's hospitals with existing PPC programs were identified to query OPPC status. An electronic survey was developed and distributed to PPC participants at each site. Survey domains included hospital and PPC program demographics; OPPC development, structure, staffing, and workflow; metrics of successful OPPC implementation; and other services/partnerships.ResultsOf 48 eligible sites, 36 (75%) completed the survey. Clinic-based OPPC programs were identified at 28 (78%) sites. OPPC programs reported a median age of 9 years [range: 1-18 years] with growth peaks in 2011, 2012 and 2020. OPPC availability was significantly associated with increased hospital size [P = 0.05] and inpatient PPC billable full time equivalent staff [P = 0.01]. Top referral indications included pain management, goals of care, and advance care planning. Funding primarily came from institutional support and billing revenue.ConclusionsAlthough OPPC remains a young field, many inpatient PPC programs are growing into the outpatient setting. Increasingly, OPPC services have institutional support and diverse referral indications from multiple subspecialties. However, despite high demand, resources remain limited. Characterization of the current OPPC landscape is crucial to optimize future growth.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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