Integration of an APP-Led Supportive and Palliative Oncology Care Program: A Quality Improvement Project

Area of Science:

• Oncology
• Palliative Care
• Quality Improvement

Background:

• Advanced cancer patients often present with severe symptoms and low quality of life.
• Early access to palliative care is crucial throughout the cancer care continuum.
• Oncology advanced practice providers (APPs) are well-positioned to integrate primary palliative care.

Purpose of the Study:

• To develop and implement an APP-led supportive and palliative oncology care (SPOC) program within routine cancer care.
• To improve patient and family experience and demonstrate APP value.

Main Methods:

• Utilized the Plan-Do-Study-Act (PDSA) methodology for program development, implementation, and analysis.
• 49 participants engaged in 239 SPOC encounters over the study period.
• Tracked patient-reported symptoms, goals of care conversations, and advance directive completion.

Main Results:

• Patients reported high symptom burden, notably pain (90%), fatigue (74%), appetite loss (59%), and weakness (55%).
• 94% of participants had documented goals of care conversations with the APP.
• A 25% advance directive completion rate was observed, with significant demand for interdisciplinary resources (136 instances).

Conclusions:

• Integrating SPOC principles into routine oncology practice enhances the patient and family experience.
• APP-led palliative care programs are effective in managing symptoms and facilitating care.
• This model demonstrates the clinical and organizational value of APPs in oncology settings.