The Intersection of Hematology and Palliative Medicine: Lessons Learned from Partnerships in Practice (SA522)

Abstract

•Review the current state of affairs with respect to Palliative Medicine and Hematology with current leaders in the field.•Discuss the perspectives, concerns, and experiences of hematology team members (physicians, nurse practitioners, and social workers) before and after the development clinical partnerships between Hematology Units (Acute Leukemia/Lymphoma & Bone Marrow Transplant) and Palliative Medicine teams.•Describe the Palliative Medicine team's experiences caring for patients with hematologic malignancies across two subpopulations: transplant and non-transplant. As palliative medicine expands within the scope of care for patients with cancer, the interface between hematologic malignancies and palliative care is increasing. These patients are underrepresented compared to their solid tumor counterparts regarding palliative care consultation. A growing body of literature supports earlier palliative care for patients with hematologic malignancies. From the impact of palliative care on bone marrow transplant patients' quality of life, utility of informatics in symptom assessment, and the role of transfusions in medical decision making regarding hospice, palliative medicine providers are afforded greater opportunity to develop successful early integration strategies. Since July 2017, the palliative medicine and hematology teams at Northwell's flagship campus partnered to enhance access to palliative care in the Acute Leukemia/Lymphoma and Bone Marrow Transplant units. Concurrently, Duke University investigators have been conducting a randomized clinical trial of early integrated palliative care during acute leukemia induction. During this session, attendees will hear leaders in the field deliver a contemporary perspective on the intersection of palliative medicine and hematology, based on these lived experiences and local implementation efforts. Subsequently, the palliative team will review the process by which this initiative was created. Next, a hematology attending and nurse practitioner from the inpatient Hematology Unit will describe their team's experiences with palliative medicine. The Bone Marrow Transplant Unit medical director and social worker will offer perspectives regarding early palliative care on their transplant patients. The Palliative Medicine team will discuss the rewards and challenges of caring for these patients, and explore the evolution of this collaboration which now provides palliative consultation for all new stem cell transplant admissions. Lastly, we will present the descriptive analytics collected prior before and during this collaboration whichwill underscore the promise of co-management models in these patient populations, concluding with a question and answer period with the panelists.