Education and referral criteria: impact on oncology referrals to palliative care.

Authors

Barbara Reville, Palliative Care Program, Hospital of the University of Pennsylvania, 1202 Penn Tower, 3400 Spruce Street, Philadelphia, PAFollow
JoAnne Reifsnyder, Genesis HealthCare, LLC, Kennett Square, PAFollow
Deborah B McGuire, University of Maryland, School of Nursing, Baltimore, MD
Karen Kaiser, University of Maryland Medical Center, Baltimore, MD
Abbie Santana, Department of Family and Community Medicine, Jefferson Medical College, Philadelphia, PAFollow

Document Type

Article

Publication Date

7-1-2013

Comments

This article has been peer reviewed. It was published in: Journal of Palliative Medicine.

Volume 16, Issue 7, 1 July 2013, Pages 786-789.

The published version is available at DOI: 10.1089/jpm.2012.0487

Copyright © Mary Ann Liebert, Inc.

Abstract

OBJECTIVE: To describe a quality improvement project involving education and referral criteria to influence oncology provider referrals to a palliative care service.

METHODS: A single group post-test only quasi-experimental design was used to evaluate palliative care service (PCS) referrals following an intervention consisting of a didactic presentation, education outreach visits (EOV) to key providers, and referral criteria. Data on patient demographics, cancer types, consult volume, reasons for referral, pre-consult length of stay, overall hospital stay, and discharge disposition were collected pre-intervention, then post-intervention for 7.5 months and compared.

SETTING AND SAMPLE: Attending oncologists, nurse practitioner, and house staff from the solid tumor division at a 700-bed urban teaching hospital participated in the project. Two geriatricians, a palliative care nurse practitioner, and rotating geriatric fellows staffed the PCS.

RESULTS: The percentage of oncology referrals to PCS increased significantly following the intervention (χ(2) = 6.108, p = .013). 24.9% (390) patients were referred in the 4.6 years pre-intervention and 31.5% (106) patients were referred during 7.5 months post-intervention. The proportion of consults for pain management was significantly greater post-intervention (χ(2) = 5.378, p = .02), compared to pre-intervention, when most referrals were related to end-of-life issues. Lung, pancreatic, and colon were the most common cancer types at both periods, and there were no significant differences in patient demographics, pre-referral length of hospitalization or overall hospital days. There was a trend toward more patients being discharged alive following the intervention.

CONCLUSION: A quality improvement project supported the use of education and referral criteria to influence both the frequency and reasons for palliative care referral by oncology providers.

Recommended Citation

Reville, Barbara; Reifsnyder, JoAnne; McGuire, Deborah B; Kaiser, Karen; and Santana, Abbie, "Education and referral criteria: impact on oncology referrals to palliative care." (2013). Department of Family & Community Medicine Faculty Papers. Paper 42.
https://jdc.jefferson.edu/fmfp/42

PubMed ID

23510168