Pediatric palliative care in China is still in its early stages. As awareness grows and demand increases, welfare institutions face the pressure to improve both emotional care and service coordination. This study focuses on how systemic design can support this transition by offering better tools, stronger networks, and more sustainable service models. This research explores how systemic design can improve pediatric palliative care within Chinese welfare institutions by addressing emotional, operational, and institutional challenges. Through a mixed-method approach—including field research, stakeholder interviews, case study analysis, and co-design workshops—the study identifies 29 opportunity points and narrows them down to 10 strategic interventions.