Early Insights from PeLTQL Integration: A QI Snapshot in Pediatric Liver Transplantation

Introduction. Psychosocial challenges often emerge before and after pediatric liver transplantation. Patient-reported outcome measures (PROMs) such as the Pediatric Liver Transplant Quality of Life (PeLTQL) questionnaire capture patient and family perspectives and provide early-warning signals. We examined our early experience integrating PeLTQL into psychosocial referrals to evaluate how PROM data complements referral questions and informs clinical impressions.

Methods. Thirty-one consecutive referrals to a clinical health psychologist (October 2025–January 2026) were reviewed for referral question, psychologist impression, next steps, PeLTQL completion, and referral–impression concordance.

Results. Of 31 referrals, 25 involved transplant recipients; 14 of 15 eligible patients completed PeLTQL. Over half of patient (55.6%) and caregiver (60%) scores fell below the <62.5 threshold, signaling need for follow-up. Referral and psychologist impressions aligned in 71% of cases; scope expanded in 26%, often for anxiety flagged by low scores or caregiver reports. Some referrals broadened to address caregiver needs, developmental concerns, or adherence strategies.

Conclusions. Integrating PeLTQL into routine care surfaces concerns beyond referral questions, enabling proactive triage and tailored interventions. Embedding PROMs within clinical pathways advances patient- and family-centered care and aligns with initiatives to operationalize quality-of-life measurement using digital platforms that return child, parent, and discrepancy scores to clinicians before visits, making PROM signals actionable within routine encounters.