- Email: [email protected]
P135 Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center
Vol. 52 No. 6 December 2016
Selected Abstracts
were asked rate the care they received on a 5 point Likert Scale e Very Poor / Poor / Fair / Good / Very Good. Results: Family members felt that Palliative Care Primary Team managed Pain (44.8% vs 21.9%) (p ¼ 0.09) and Delirium better (64.7% vs 14.3%) (p ¼ 0.08). Families also felt that the Palliative Care Primary Team attended to patient’s emotional needs (53.3% vs 30.0%) (p ¼ 0.01) and caregivers emotional needs (75.0% vs 41.7%) (p LT 0.001). 90.0% would recommend the Palliative Care Primary team to others facing a similar situation compared to non-palliative care teams (73.3%) (p ¼ 0.02). Discussion and Conclusion: Patients experienced better control of pain, delirium and dyspnea when under palliative care primary teams. Family members also felt that patient and their own emotional needs were better supported and would recommend the Palliative Care team to others going through a similar situation.
with one needing hospital admission. 21 patients required additional counseling: 2 for hospice transitioning, 12 for psychosocial distress, and 7 for opioid education. PC was delivered predominantly by physicians and nurses with close collaboration with our pharmacist, counselors, and case manager. Of these cases, 9 will be presented to show the diversity of cases, scope of services, and the unique roles that of each member of the PC IDT perform. Conclusion: In recent years, OP centers have dramatically changed the nature of PC work as reflected in this patient cohort. Patients increasingly present to OP SCCs with complex issues, at different stages of disease and requiring expertise from the various members of the IDT. Our findings suggest that a team approach to address a variety of symptom and education needs is crucial. More research is needed to improve the quality of the process of PC delivery by an IDT and to identify barriers to utilization of the IDT for best patient outcomes.
The presence of a Palliative Care Primary Care team in an acute hospital improves patient and family outcomes for patients near the end-of-life.
Leadership, Program Development and Evaluation, Policy Development and Advocacy
P135 Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center
P139 Early Integration of Palliative Care in Ontario: INTEGRATE Quality Improvement Project
Lindsey E. Pimentel, Maxine De la Cruz, Angelique Wong, Debra Castro, Eduardo Bruera, MD, Anderson Cancer Center, Houston, TX, United States Background: Integration of Palliative Care (PC) in oncology has been found to improve symptom distress, quality of life, and survival in patients with advanced cancer. However, most PC services in the United States do not have an outpatient (OP) component where most oncology care is delivered. Methods: A retrospective chart review of patients treated on one clinic day was conducted to evaluate the type and reason for visit, symptom burden at time of visit, and utilization of the interdisciplinary team (IDT) for patient care. Results: Forty-one patients were seen that day in the SCC: 10 scheduled consults, 22 scheduled follow-ups, 9 (22%) same-day unscheduled patients: 4 followups, 1 consult and 4 nurse triages. There were also 31 telephone encounters. Most patients seen were for routine follow-up and assessment of symptoms. However, 10 presented with worsening symptoms
e101
Sandy Buchman1, Frances Wright1,2, Marnie MacKinnon1, Tara Walton3, Erin Arthurs1, Yanchini Rajmohan1, Redinela Mani1 1 Cancer Care Ontario, CCO, Toronto, ON, Canada 2 Department of Surgery, University of Toronto, Toronto, ON, Canada 3 Ontario Palliative Care Network, Toronto, ON, Canada Objectives: Introducing palliative care early in the cancer journey results in a better quality of life, less aggressive care and longer survival. The goal of the INTEGRATE Project is to identify and manage patients who would benefit from a palliative approach to care early in the illness trajectory and across healthcare settings. Methods: Palliative care integrated models are being pilot tested in 4 regions in Ontario, Canada (4 cancer centres (CCs) and 4 PC practices). All sites completed Pallium Canada’s LEAP module, which provides primary level palliative care education. The need for a palliative care approach for given a patient is identified using the Surprise Question ‘Would you be surprised if this person died in the next 6-12 months?’, initiating symptom assessment, Advanced Care
Selected Abstracts
were asked rate the care they received on a 5 point Likert Scale e Very Poor / Poor / Fair / Good / Very Good. Results: Family members felt that Palliative Care Primary Team managed Pain (44.8% vs 21.9%) (p ¼ 0.09) and Delirium better (64.7% vs 14.3%) (p ¼ 0.08). Families also felt that the Palliative Care Primary Team attended to patient’s emotional needs (53.3% vs 30.0%) (p ¼ 0.01) and caregivers emotional needs (75.0% vs 41.7%) (p LT 0.001). 90.0% would recommend the Palliative Care Primary team to others facing a similar situation compared to non-palliative care teams (73.3%) (p ¼ 0.02). Discussion and Conclusion: Patients experienced better control of pain, delirium and dyspnea when under palliative care primary teams. Family members also felt that patient and their own emotional needs were better supported and would recommend the Palliative Care team to others going through a similar situation.
with one needing hospital admission. 21 patients required additional counseling: 2 for hospice transitioning, 12 for psychosocial distress, and 7 for opioid education. PC was delivered predominantly by physicians and nurses with close collaboration with our pharmacist, counselors, and case manager. Of these cases, 9 will be presented to show the diversity of cases, scope of services, and the unique roles that of each member of the PC IDT perform. Conclusion: In recent years, OP centers have dramatically changed the nature of PC work as reflected in this patient cohort. Patients increasingly present to OP SCCs with complex issues, at different stages of disease and requiring expertise from the various members of the IDT. Our findings suggest that a team approach to address a variety of symptom and education needs is crucial. More research is needed to improve the quality of the process of PC delivery by an IDT and to identify barriers to utilization of the IDT for best patient outcomes.
The presence of a Palliative Care Primary Care team in an acute hospital improves patient and family outcomes for patients near the end-of-life.
Leadership, Program Development and Evaluation, Policy Development and Advocacy
P135 Snapshot of an Outpatient Supportive Care Center at a Comprehensive Cancer Center
P139 Early Integration of Palliative Care in Ontario: INTEGRATE Quality Improvement Project
Lindsey E. Pimentel, Maxine De la Cruz, Angelique Wong, Debra Castro, Eduardo Bruera, MD, Anderson Cancer Center, Houston, TX, United States Background: Integration of Palliative Care (PC) in oncology has been found to improve symptom distress, quality of life, and survival in patients with advanced cancer. However, most PC services in the United States do not have an outpatient (OP) component where most oncology care is delivered. Methods: A retrospective chart review of patients treated on one clinic day was conducted to evaluate the type and reason for visit, symptom burden at time of visit, and utilization of the interdisciplinary team (IDT) for patient care. Results: Forty-one patients were seen that day in the SCC: 10 scheduled consults, 22 scheduled follow-ups, 9 (22%) same-day unscheduled patients: 4 followups, 1 consult and 4 nurse triages. There were also 31 telephone encounters. Most patients seen were for routine follow-up and assessment of symptoms. However, 10 presented with worsening symptoms
e101
Sandy Buchman1, Frances Wright1,2, Marnie MacKinnon1, Tara Walton3, Erin Arthurs1, Yanchini Rajmohan1, Redinela Mani1 1 Cancer Care Ontario, CCO, Toronto, ON, Canada 2 Department of Surgery, University of Toronto, Toronto, ON, Canada 3 Ontario Palliative Care Network, Toronto, ON, Canada Objectives: Introducing palliative care early in the cancer journey results in a better quality of life, less aggressive care and longer survival. The goal of the INTEGRATE Project is to identify and manage patients who would benefit from a palliative approach to care early in the illness trajectory and across healthcare settings. Methods: Palliative care integrated models are being pilot tested in 4 regions in Ontario, Canada (4 cancer centres (CCs) and 4 PC practices). All sites completed Pallium Canada’s LEAP module, which provides primary level palliative care education. The need for a palliative care approach for given a patient is identified using the Surprise Question ‘Would you be surprised if this person died in the next 6-12 months?’, initiating symptom assessment, Advanced Care