Enhancing Early Integration of Pediatric Palliative Care: Evaluating a Clinician-Based Versus Criteria-Based…

Cohort studyChildren (Basel, Switzerland)· Jul 2026

Enhancing Early Integration of Pediatric Palliative Care: Evaluating a Clinician-Based Versus Criteria-Based Referral Process in Pediatric Oncology.

Alexis Fong-Leboeuf, Christina Vadeboncoeur, Donna L Johnston

OncologyCohort studyClinical practiceQ1IF 2.8

Palliative care referral criteria linked to faster referral, median 11 days after diagnosis

Enhancing Early Integration of Pediatric Palliative Care: Evaluating a Clinician-Based Versus Criteria-Based Referral Process in Pediatric Oncology.

Alexis Fong-Leboeuf … Donna L Johnston

Children (Basel, Switzerland) · Jul 2026

Background

Early palliative care referral for new oncologic diagnoses has been widely recognized as integral to comprehensive care, but there exists a paucity of research assessing referral patterns in pediatric oncology.

Purpose

The objective of this study is to review the change in referral patterns at the Children's Hospital of Eastern Ontario (CHEO) before and after a set of referral criteria were implemented for routine consultation of pediatric palliative care (pediatric palliative care) for all newly diagnosed oncology patients.

Methods

This was a retrospective single-centre chart review of all patients with a new oncologic diagnosis from 21 October 2017 to 1 January 2024 using information available in the patient's electronic medical record.

n = 226 patients

Results

referrals now happen days after diagnosis, not months

36.8%

Before criteria

75.4%

After criteria

More results

A total of 504 chart reviews were completed and 226 patients were referred to pediatric palliative care.

The proportion of patients referred to pediatric palliative care showed a statistically significant increase from 36.8% to 75.4% after introduction of pediatric palliative care referral criteria (χ2(1) = 44.98, p < 0.001).

More results

Time to referral decreased significantly across all diagnostic subgroups except for CNS tumours.

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Conclusion · 1 of 2

Having referral criteria for consultation to pediatric palliative care increased the proportion of oncology patients referred to pediatric palliative care and resulted in a significant decrease in time to referral.

Conclusion · 2 of 2

These findings suggest that structured referral criteria support earlier integration of pediatric palliative care within oncology programmes.

Enhancing Early Integration of Pediatric Palliative Care: Evaluating a Clinician-Based Versus Criteria-Based Referral Process in Pediatric Oncology.

Enhancing Early Integration of Pediatric Palliative Care: Evaluating a Clinician-Based Versus Criteria-Based Referral Process in Pediatric Oncology.

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