Outpatient Legacy Building: A Survey of Children’s Hospitals

Although the definition of legacy remains elusive, the literature describes legacy building as activities that promote lasting meaning during healthcare experiences. Legacy building is often offered to inpatient pediatric patients with life-threatening diagnoses. Recent studies have aimed to explain the importance of and perception of inpatient legacy building interventions. This study evaluated legacy building offered to outpatient pediatric patients. Researchers electronically surveyed National Association of Children’s Hospitals and Related Institutions (NACRI), now Children’s Hospital Association (CHA), member hospitals regarding their legacy building interventions. Child life and nursing professionals from 48 hospitals completed the survey; 43 have outpatient settings at their institution. Fourteen percent ( n = 6) of respondents reported not offering any legacy building opportunities to their outpatient population, whereas 7% ( n = 3) of respondents reported not offering legacy building at their facility at all. Respondents attributed this decrease to time constraints, lack of support from multidisciplinary staff, and limited resources. Most interventions were initiated when no further treatment was being pursued rather than earlier in an illness trajectory. Implications for practice include dedicated child life coverage in clinical settings, partnering with nonprofit organizations to offer legacy building opportunities, and ongoing education to increase multidisciplinary buy-in. Further studies should evaluate service expansion opportunities earlier in an illness trajectory. Additionally, costs and benefits of outpatient clinic legacy building should be investigated.