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Developing a model for embedded palliative care in a cancer clinic
  1. Susan DeSanto-Madeya1,2,
  2. David McDermott2,3,
  3. Jessica A Zerillo2,
  4. Nancy Weinstein2 and
  5. Mary K Buss2,3
  1. 1Boston College, Wm. F.Connell School of Nursing, Chestnut Hill, Massachusetts, USA
  2. 2Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
  3. 3Harvard Medical School, Boston, Massachusetts, USA
  1. Correspondence to Dr Susan DeSanto-Madeya, 140 Commonwealth Ave, Chestnut Hill, MA 02467, USA; Susan.desanto-madeya{at}bc.edu

Abstract

Objectives Describe the development and key features of a model for embedded palliative care (PC) for patients with advanced kidney cancer or melanoma seen in a cancer clinic.

Methods Retrospective chart review of patients following an initial phase and then a prospective review following the implementation of a model for embedded PC.

Results In the initial phase, 18 patients were seen for a total of 53 visits; 78% were seen more than once, with a mean of three visits per patient. In the model phase, 46 patients were seen for a total of 163 visits; 74% were seen more than once, with a mean of 3.5 visits. Demographics were similar between the two groups. Content of the first PC visit in the initial and model phases was symptom management (61% and 57%), psychosocial support/relationship building (28% and 35%) and advance care planning/decision-making support (11% and 8%), respectively.

Conclusions The initial phase demonstrated acceptability and feasibility of a model for embedded PC for patients and the oncology team. Establishment of specific eligibility criteria and screening to identify eligible patients in the model phase led to an increased uptake of PC for patients with advanced kidney cancer and melanoma in a cancer clinic.

  • model
  • embedded palliative care
  • Received 3 January 2017.
  • Accepted 10 February 2017.

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  • Received 3 January 2017.
  • Accepted 10 February 2017.
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Footnotes

  • Contributors SD-M was responsible for all aspects of the study and overall content. SD-M and MKB designed the study. SD-M, DM, JAZ, NW and MKB contributed to the planning of the study and writing of the report.

  • Funding This work was supported by the Center for Healthcare Quality, Beth Israel Deaconess Medical Center, Boston, MA, Innovation Grant.

  • Competing interests None declared.

  • Ethics approval Beth Israel Deaconness Medical Center (BIDMC) IRB.

  • Provenance and peer review Not commissioned; internally peer reviewed.

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