Translating Evidenced-Based Guidelines into Clinical Practice using Goal Setting and Palliative Program Dashboards (GP772)

Abstract

• State sources of evidence-based palliative care guidelines• Describe methods of determining appropriate quality measures for individual practice• State potential outcomes/benefits of utilizing dashboards for guideline implementation. Palliative medicine practice is increasingly informed by evidence from clinical trials performed in academic medical centers. This evidence informs national practice guidelines, such as the National Consensus Project (NCP) and American Society of Clinical Oncology, aimed at improving quality of patient care. Translating these evidence-based guidelines into clinical practice is difficult due to resource limitations and lack of established models of palliative care delivery. This leads to gaps between published guidelines and clinical practice, particularly in the community setting. 1. State sources of palliative care guidelines 2. Describe methods of determining appropriate quality measures for individual practice 3. State potential outcomes/benefits of utilizing dashboards for guideline implementation Two palliative care programs, one academic and one community-based, translated guidelines into practice using interdisciplinary goal setting and creation of palliative care dashboards.The programs compared their practice to national guidelines to identify opportunities for improvement. Goals identified included implementation of opioid risk assessment, chemotherapy at end of life, 30-day readmissions, and frequency of palliative consultation for patients with advanced lung cancer. The outpatient Penn Medicine Lancaster General Health program, providing primarily Palliative Care in Oncology, used program dashboards to measure and encourage progress on identified goals, resulting in >50% improvement in measures such as palliative consultation for advanced cancers. Penn State Health Palliative Care implemented dashboard goals informed by NCP guidelines including psychosocial support and advance care planning completion. This led to >60% improvement in measured outcomes during the first year of implementation. Goal setting and creation of program dashboards can facilitate application of palliative guidelines.