• Katherine M Bernier Carney, George Goodrich, Amberly Lao, Zewen Tan, Alfred Habamutaki Kiza, Xiaomei Cong, and Katherine A Hinderer.
• School of Nursing, University of Connecticut, Storrs, CT, USA.
• Palliat Med. 2023 May 1; 37 (5): 692706692-706.

BackgroundSpecialty pediatric palliative care services can help to address unmet care needs for children with complex and serious illness. Current guidelines support the identification of unmet palliative care needs; however, it is unknown how these guidelines or other clinical characteristics influence pediatric palliative care referral in research and practice.AimTo evaluate the identification and application of palliative care referral criteria in pediatric illness care and research.DesignA scoping review with a content analysis approach to summarize results.Data SourcesFive electronic databases (PubMed, CINAHL, PsycINFO, SCOPUS, and Academic Search Premier) were used to identify peer-reviewed literature published in English between January 2010 and September 2021.ResultsWe included 37 articles focused on the referral of pediatric patients to palliative care teams. The identified categories of referral criteria were: disease-related; symptom-related; treatment communication; psychosocial, emotional, and spiritual support; acute care needs; end-of-life care needs; care management needs; and self-referrals for pediatric palliative care services. We identified two validated instruments to facilitate palliative care referral and seven articles which described population-specific interventions to improve palliative care access. Nineteen articles implemented a retrospective health record review approach that consistently identified palliative care needs with varying rates of service use.ConclusionsThe literature demonstrates inconsistent methods for identifying and referring children and adolescents with unmet palliative care needs. Prospective cohort studies and clinical trials would inform more consistent pediatric palliative care referral practices. More research is needed on palliative care referral and outcomes in community-focused pediatrics.

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