Oncologists’ perceptions of rounding alongside palliative care physicians: Results of a post-intervention survey study.

Abstract

e20674 Background: In August 2011, a new rounding model was instituted on the inpatient solid tumor oncology service at Duke. This model incorporated a palliative care physician as a second attending on service, alongside the rounding solid tumor oncologist. We sought to assess the oncologists’ perceptions of this model, and of palliative care, 1 year later. Methods: We developed a 15-item survey assessing 3 domains: (1) perceptions about palliative care in general, (2) lessons learned from palliative care colleagues, if any, and (3) changes in the experience of rounding on the solid tumor oncology service. Faculty were invited to participate by e-mail, via an anonymous web link. All oncology faculty who rounded at least 2 weeks since August 2011 were included. Results: Response rate was 73% (8 of 11). 75% (N=6) of respondents had rounded both before and after the new model was instituted. 75% reported a more positive perception of palliative care (N=6), 88% (N=7) reported learning new ways to manage cancer patients’ symptoms, and 100% agreed that the palliative care physician brings a valuable skill set to the team. Only 1 respondent felt that palliative care physicians detract from oncologic issues, and none thought the palliative care physicians discuss hospice too early. 88% (N=7) reported greater willingness to round on the service under the new model, and 100% agreed that rounding was more enjoyable since the addition of the palliative care attending to the team. 100% agreed that palliative care is a necessary component of comprehensive cancer care, and that palliative care should have a presence in the outpatient cancer clinics; 88% (N=7) reported feeling comfortable doing palliative care in their own clinical practice. All agreed that “palliative care” is different from “hospice care.” Conclusions: Rounding alongside palliative care physicians on an inpatient oncology service may improve oncologists’ perceptions of palliative care, teach them new symptom management skills, and improve their willingness to do inpatient rounding. Fears about palliative care physicians inappropriately introducing hospice too early for patients with solid tumors may be unfounded.