scholarly journals Utilization of Supportive and Palliative Care Services among Oncology Outpatients at One Academic Cancer Center: Determinants of Use and Barriers to Access

2012 ◽  
Vol 15 (8) ◽  
pp. 923-930 ◽  
Author(s):  
Pallavi Kumar ◽  
David Casarett ◽  
Amy Corcoran ◽  
Krupali Desai ◽  
Qing Li ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Center ◽  
Care Services ◽  
Barriers To Access ◽  
Palliative Care Services

scholarly journals Using Quality Improvement to Increase Access to Palliative Care

2020 ◽  
pp. OP.20.00469
Author(s):  
Kate Lally ◽  
Isaac S. Chua ◽  
Nancy U. Lin ◽  
Jocelyn Siegel ◽  
Rachelle Bernacki
Keyword(s):  
Palliative Care ◽  
Gynecologic Cancer ◽  
Steering Committee ◽  
Cancer Center ◽  
Pilot Program ◽  
Care Services ◽  
Barriers To Access ◽  
Palliative Care Services ◽  
Notable Increase ◽  
Barriers And Opportunities

PURPOSE: As part of a larger effort to integrate palliative care into a cancer center, we identified barriers to palliative care referral for patients with breast or gynecologic cancer and developed a pilot program to improve access to palliative care services. METHODS: We developed a multidisciplinary steering committee to uncover barriers to palliative care referral and developed a pilot program, called the Warm Handoff. Through ongoing collaboration and midpilot feedback sessions, we identified several additional barriers and opportunities to increase access to palliative care. RESULTS: Clinicians used the initial Warm Handoff process only 20 times over a period of 7 months. Of those calls, 10 were for issues outside of those that the Warm Handoff pilot was intended to address. During the pilot, we identified lack of access to urgent visits and clinician telephone availability for clinical case discussion as additional barriers to access. Increased collaboration led to the creation of a clinical provider of the day (CPOD) care model, which allowed for a notable increase in the capacity to see urgent consults. After this intervention, we observed an average of 19 patients seen urgently per month. In addition, there was a trend toward increasing referrals from breast oncology after the initiation of the CPOD. CONCLUSION: A CPOD model, developed via close oncology/palliative care collaboration, resulted in increased utilization of palliative care services.

Integration and expansion of palliative care work force.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 126-126
Author(s):  
Lynn Bowlby ◽  
Robin Turner ◽  
David Casarett ◽  
Fred Johnson ◽  
Ebony Boulware ◽  
...  
Keyword(s):  
Palliative Care ◽  
Faculty Member ◽  
Training Program ◽  
Fellowship Training ◽  
Cancer Center ◽  
Severe Illness ◽  
Care Clinic ◽  
Intensive Training ◽  
Care Services ◽  
Palliative Care Services

126 Background: The specialty of Hospice and Palliative Medicine has grown out of the need for care of patients who are living longer with cancer and other serious illness and struggle with symptoms, decisions and care. Cancer patients and others often do not have access to Palliative Care services due to availability or accessibility of PC services. Since 2012, fellowship training is required for board eligibility but available programs do not meet the workforce need. As described by Weissman and Meier, viewing Palliative care services in the context of a primary, secondary or tertiary focus , allows for the expansion of these services outside of the traditional fellowship training. With additional intensive training, it is possible that experienced physicians can fill workforce gaps by providing primary palliative care in the providers practice area such as a clinic. Methods: The faculty member who will participate in a yearlong training program based in the Palliative Care Clinic is the Director of the Outpatient Clinic. This clinic is the center of the Duke resident ambulatory experience for the duration of their training. The complexity of these patients is high and often the DOC is the only place that these patients receive care. The Palliative Care training program will provide the faculty member the opportunity to see patients in the cancer center with board certified palliative care physicians. There will be 3 areas of focus for the trainee: clinical experience, didactic information and mentorship from a board certified palliative care provider around faculty identified cases from her own practice. Results: We have developed a yearlong intensive training program for experienced faculty to gain skills in Palliative Care. Conclusions: 1. It is hoped that this will allow for integration of primary palliative care into patient care areas where there is no formal palliative care program. 2. Integration of Palliative Care principles in the clinic to address symptoms of chronic severe illness as well as difficult conversations with more confidence and skill. 3. Earlier palliative care management–develop a systematic approach to assessing needs in high risk populations ie. Hospital Discharge reviews, now commonly done at the clinic.

scholarly journals Palliative Care Services at Cancer Center Janakpur, Nepal

2020 ◽  
Author(s):  
Sanjay Gupta ◽  
Richa Mishra ◽  
Anshu kumar Thakur ◽  
pamesh pamesh
Keyword(s):  
Palliative Care ◽  
Cancer Center ◽  
Care Services ◽  
Palliative Care Services

Perspectives on palliative care in a multisite oncology practice.

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 52-52
Author(s):  
Kenneth D. Bishop ◽  
Angela Marie Taber
Keyword(s):  
Palliative Care ◽  
Pain Management ◽  
Cancer Patients ◽  
Nurse Practitioners ◽  
Effective Means ◽  
Cancer Center ◽  
Care Services ◽  
Palliative Care Consultation ◽  
Palliative Care Services ◽  
Care Consultation

52 Background: The Institute of Medicine reported that many cancer patients do not receive palliative care to manage symptoms. It is possible that practitioners do not identify palliative care as an important component of high-quality cancer care, or do not know how to most efficiently utilize available palliative care consultative services. Methods: An anonymous electronic survey was sent to physicians, nurses, nurse practitioners, physician assistants, and social workers (n=99) in our multi-site, single-institution Cancer Center. Results: Sixty-five responses were received (66% response rate). Eighty-three percent of respondents reported working primarily in the outpatient setting. Fifty-nine percent reported their patients ‘rarely use the ER for pain management’ while 16% reported their patients ‘frequently require ER visits for pain management’. Ninety-two percent considered palliative care ‘an integral part of a multidisciplinary team’ while 6% reported palliative care consultation to be ‘cumbersome to consult and coordinate with’. The most common reason for consultation was end-of-life discussions (38%) followed by chronic pain management (33%). Seventy-seven percent reported consulting between 1 and 5 times per month, 14% between 6-10 times per month, and 5% greater than 11 times per month. Thirteen percent reported that they were able to manage patient symptoms adequately themselves. The average rating for convenience of consulting palliative care was 3.8/5. Fifty-eight percent reported the most effective means of communication with palliative care consultants was through the medical record, whereas 42% reported that most effective communication took place in person. Sixty percent reported a preference for palliative care practitioners from within the division of hematology/oncology. Conclusions: Our survey suggests that the majority of oncology practitioners value palliative care consultation and are willing to incorporate palliative care services into patient management. It is possible that practitioners overestimate their utilization of palliative care services and that optimizing the convenience of consultation and communication would result in better integration of palliative care for cancer patients.

Effect of patient education on palliative care knowledge and acceptability of outpatient palliative care service among gynecologic oncology patients.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11583-11583 ◽  
Author(s):  
Ashley Graul ◽  
Ashley Ford Haggerty ◽  
Carolyn Stickley ◽  
Pallavi Kumar ◽  
Knashawn Morales ◽  
...  
Keyword(s):  
Palliative Care ◽  
Care Service ◽  
Gynecologic Oncology ◽  
Tertiary Care ◽  
Palliative Care Service ◽  
Cancer Center ◽  
Educational Video ◽  
Oncology Patients ◽  
Care Services ◽  
Palliative Care Services

11583 Background: This was a randomized control trial to estimate the effect of an interventional video on improving palliative care knowledge and acceptability of outpatient services in gynecologic oncology patients. Methods: Women receiving active treatment for gynecologic malignancy (persistent or progressive disease despite primary treatment) were recruited at an academic tertiary care center from 2/2018 to 1/2019 and randomized to: palliative care educational video or non-directive cancer center informational video (control). The primary outcome was desire for referral to palliative care. Function and knowledge were assessed using the Functional Assessment of Cancer Therapy (FACT-G) and the Palliative Care Knowledge Scales. Data analyses were performed using t-tests, Wilcoxon rank sum or Fisher’s exact tests with significance level of α=0.05. Results: 111 women were enrolled. Demographic characteristics were equally distributed between groups (mean age 63.4 vs 65.4 years; 78% vs 82% Caucasian, 58% vs 68% stage III, 71% vs 64% ovarian cancer, 65% vs 72% platinum-sensitive). There was no statistical difference in knowledge scores or in desire for referral to palliative care (29% vs 27%; p=0.79). Secondary analysis showed a statistically significant increase in utilization of palliative care services compared to historic institutional data (8.8% to 29.7%; p=<0.001). Further, those that desired referral had significantly worse FACT-G scores at time of referral choice (table). Conclusions: Use of a palliative care educational video did not increase knowledge or acceptability of palliative care services within this RCT. However, the rate of patients seeking palliative care referral tripled compared to historic rates. Further studies should investigate whether discussion regarding palliative care services alone may increase desire for referral, and if use of Fact-G scores may identify patients in greatest need of services. [Table: see text]

Palliative care for vulnerable populations

2012 ◽  
Vol 10 (1) ◽  
pp. 37-42 ◽  
Author(s):  
Deborah Stienstra ◽  
Harvey Max Chochinov
Keyword(s):  
Palliative Care ◽  
End Of Life ◽  
Vulnerable Populations ◽  
Healthcare Providers ◽  
Care Services ◽  
Barriers To Access ◽  
Whole Person ◽  
Palliative Care Services ◽  
Support Team ◽  
Hospice And Palliative Care

AbstractObjective:The purpose of this article is to identify how inclusive and accessible palliative care can be achieved for all, including those labelled as vulnerable populations.Method:Drawing on a review of existing literature as well the research of the Vulnerable Persons and End-of-Life New Emerging Team (VP-NET), this article reflects on what changes can be made within palliative care to make it more inclusive.Results:Experiences of marginalization often result, intentionally or unintentionally, in differential treatment in healthcare. This increased vulnerability may result from attitudes of healthcare providers or from barriers as a result of “normal” care practices and policies that may exclude or stigmatize certain populations. This may include identifying when palliative care is necessary, who receives palliative care and where, and what is necessary to complement palliative care.Significance of results:Inclusive and accessible palliative care can become possible through building on the existing strengths in palliative care, as well as addressing existing barriers. This may include treating the whole person and that person's support team, including paid support workers, as part of the unit of care. It involves ensuring physically accessible hospice and palliative care locations, as well as thinking creatively about how to include those excluded in traditional locations. Inclusive palliative care also ensures coordination with other care services. Addressing the barriers to access, and inclusion of those who have been excluded within existing palliative care services, will ensure better palliative and end-of-life care for everyone.

scholarly journals Use of Palliative Care Services in a Tertiary Cancer Center

2015 ◽  
Vol 21 (1) ◽  
pp. 110-118 ◽  
Author(s):  
Shalini Dalal ◽  
Sebastian Bruera ◽  
David Hui ◽  
Sriram Yennu ◽  
Rony Dev ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Center ◽  
Care Services ◽  
Palliative Care Services ◽  
Tertiary Cancer Center

scholarly journals Referral Time of Advance Cancer Patients to Palliative Care Services and Its Predictors in Specialized Cancer Center

Cureus ◽  
2020 ◽  
Author(s):  
Nabil ALMouaalamy ◽  
Khaled AlMarwani ◽  
Abdulmajeed AlMehmadi ◽  
Ahmed A AlNakhli ◽  
Yasser AlGhamdi ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Cancer Center ◽  
Care Services ◽  
Palliative Care Services

scholarly journals Barriers to Access to Palliative Care

2017 ◽  
Vol 10 ◽  
pp. 117822421668888 ◽  
Author(s):  
Pippa Hawley
Keyword(s):  
Palliative Care ◽  
Health Care Professionals ◽  
Care Service ◽  
Palliative Care Service ◽  
Early Integration ◽  
Care Services ◽  
Life Threatening Illness ◽  
Barriers To Access ◽  
Palliative Care Services ◽  
Life Threatening

Despite significant advances in understanding the benefits of early integration of palliative care with disease management, many people living with a chronic life-threatening illness either do not receive any palliative care service or receive services only in the last phase of their illness. In this article, I explore some of the reasons for failure to provide palliative care services and recommend some strategies to overcome these barriers, emphasizing the importance of describing palliative care accurately. I provide language which I hope will help health care professionals of all disciplines explain what palliative care has to offer and ensure wider access to palliative care, early in the course of their illness.

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