Abstract
134 Background: It is now well established that palliative care is an integral part of cancer treatment, recommended by the National Cancer Comprehensive Network for evidence based practices. Palliative care in this setting has been shown to improve symptom burden, enhance quality of life, reduce cost, and extend survival. Partners in Care is a non-profit, community-based hospice/home health agency in Bend OR, and consistent with national trends, receives late oncology referrals to hospice. Partnership with a multispecialty group was established to allow for a palliative care specialist to be embedded into their oncology clinic. Methods: Palliative care consults are offered 2 days/week in the oncology clinic. Triggers have been created to facilitate consultation. Quality metrics have been carefully tracked and include symptom scores, advance care planning, and transition and length of stay for hospice referrals. Financial support has been provided through grant funding from local insurance and community foundations. Results: In the first 10 months, 116 new oncology patients were seen, and had an average 1.9 visits. Documented ACP discussions occurred in 85% patients. Of patients with moderate to severe pain and dyspnea, scores improved by 65% and 50% respectively. Length of stay on hospice increased from 26 to 36 days. All of the patient respondents surveyed would recommend our service to others. Provider respondents 100% strongly agree that objectives were met when they requested a palliative care consult. Conclusions: Palliative care has been successfully integrated into a community-based oncology practice, resulting in increased access to palliative care, increased utilization of and length of stay on hospice, improved symptom management, increased use of ACP, and enhanced patient/family satisfaction. Having palliative care embedded in the clinic has resulted in better coordination of care and ease of communication. Future directions include using QDACT (Quality Data Collection Tool) to better track quality measures, inclusion of a social worker, and alignment with insurers and ACOs for cost support and data analytics.
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