Abstract
medical oncology (MO) and palliative care (PC) physicians. The American Society of Clinical Oncology (ASCO) recently recommended that palliative care be considered early in the treatment of patients with metastatic cancer. We designed and implemented a fully integrated PC/MO rounding model for the solid tumor inpatient service at Duke University Medical Center. We performed an early analysis of quality metrics data, including length of stay (LOS), readmission rates (RR), and intensive care unit (ICU) transfers, to compare its impact with pre-implementation data. Methods. A fully-integrated inpatient rounding model was created and consisted of two attendings (one MO, one PC), one hematology-oncology fellow, two interns, four physician assistants, and two patient resource managers. All patients were discussed in a multidisciplinary fashion three times a day. Quality metrics and performance services data were assessed from the first 3 months of full implementation (OctoberDecember 2011) and compared to data from the previous calendar year (January-December 2010) with the only difference being the integration of PC. Summary statistics will be reported. Results. The average daily census during postmodel implementation was 24 patients with approximately one-third of patients being directly managed by PC during the first 3 months of implementation. Implementation of the integrated PC/MO rounding model revealed a decrease in the average LOS of 0.5 days. Seven and 30-day RR decreased by 55% (11% to 5%, preand post-implementation) and 30% (33% to 23%, preand post-implementation), respectively. ICU transfer decreased by 28% (4.7% to 3.4%). Final data, including full statistical analyses, will be shared at the formal presentation. Conclusions. Our data highlight a unique and fully integrated inpatient rounding model between PC and MO. Preliminary analyses show significant improvement in several quality metrics and support ongoing investigation into this novel approach.
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