Presentation description

15-20% of children with cancer will still die despite best clinical care. Over half of those children who die from cancer will die in an inpatient setting. When a child's death is anticipated, family goals should be heard and used to give medical recommendations that align with optimal end-of-life care. Sensitive, detailed discussions with guidance about potential benefits and burdens of medical choices are needed as a child declines and cure becomes unreachable. Personalized medical decisions should be well documented and made known to all caregivers and providers involved to eliminate duplicate difficult conversations with families. Care preferences should be documented in the EMR and shared with the medical team in real time as transitions may happen quickly.​ Our aim is to identify current institutional patterns in medical provider documentation of crucial conversations and EOLC choices for children who die inpatient at Primary Children's Hospital from cancer. A retrospective review of EMR EOL documentation will catalog the current state of EOLC planning for pediatric oncology patients at Primary Children's Hospital and serve as baseline data for development and implementation of a standardized process for streamlined communication and documentation regarding goals of care for cancer patients choosing to die in the inpatient setting. Our team will review clinical documentation of EOLC metrics over the last 7 years for pediatric oncology patients who died from refractory cancer as an inpatient at PCH. This data will represent the current state of EOLC planning for patients in the inpatient oncology setting.