ES13.06 Developing a Care Board

Abstract

Interprofessional supportive care improves patient’s quality of life and might even impact overall survival In the Department of Oncology at Lausanne University Hospital (CHUV) we developed and introduced an interprofessional board called “Care-Board” during early treatment phase that is organized in parallel to the Tumor-Board The aim of the Care-Board is to facilitate a standardised interprofessional consensus process and agreement on supportive care recommendations for patients Between 2017-2018, we piloted the Care-Board targeted on patients diagnosed with lung cancer This pilot study showed promising results for the feasibility and acceptability of the Care-Board Indeed all participating health care professionals declared to be favorable to continue the Care-Board in the future and integrate this model in the usual care for lung cancer patients It was also found that the goal of the Care-Board needed clarification and clear inclusion criteria evaluating the complexity of patients’ supportive care needs was recommended It was also recommended to open the Care Board to other patient groups and to increase the frequency of Care Boards to allow a rapid action to address problems and needs In 2020 we introduced a new model of the Care Board open to all cancer patients fulfilling the following inclusion criteria: clinical evidence of moderate / high distress (score >4 on the NCCN distress thermometer) and/or a high number of problems on the problem checklist, and/ or management by the oncology team and available resources / referral to specialist does not sufficiently allow to address the distress / problems The Care Board is led by an oncology nurse (Care Board Coordinator) and includes oncologists, oncology nurses, oncology APNs, palliative care specialists, psycho-oncologists, integrative medicine, social worker, nutritionists, spiritual care They meet weekly for one hour, each member can refer patients to the board Between February and November 2020 we held 29 care boards (main reason for missed care-boards: 1st wave of COVID-19 (n=10), lack of referred cases (n=9) The average time duration of weekly Care Board was 50 min and on average one new patient was discussed per Care Board, in total 33 new patients were discussed Of these, 48% (n=16) were previously screened with the NCCN Distress Thermometer These screened patients showed a mean distress score of 4 and indicated on average 15 problems on the problem checklist Most cases were referred by oncology nurses (n=11;33%) and oncology APNs (n=17;55%) 55% of referred patient situations were lung cancer patients, followed by brain tumor patients (15%) and gastro-intestinal cancer patients (12%) The main supportive care areas discussed in the Care Board were psychological problems (anxiety, fear, worry, nervousness, isolation) physical problems (fatigue, nausea, loss of appetite, sleep disorders) and financial problems These early results show that the Care Board is feasible and is accepted by health care professionals caring for lung cancer patients Early feasibility results for other patient groups are promising We continue the development and have the intention to conduct research to enable the development of an evidence based Care Board model