Consultation patterns before and after embedding pediatric palliative care into a pediatric hematology/oncology clinic

Title

Consultation patterns before and after embedding pediatric palliative care into a pediatric hematology/oncology clinic

Creator

Greenmyer JR; Ngo T; Smith M; Collura C; Schiltz B; McCarthy SR

Identifier

Publisher

Pediatric Blood and Cancer

Date

2023

Subject

child; Palliative Care; article; controlled study; female; human; male; retrospective study; outpatient; palliative therapy; Referral and Consultation; Hematology; clinical article; consultation; medical record review; solid tumor; rank sum test; hematology; cancer model; health care delivery; embedding

Description

Introduction: Palliative care is a critical component of pediatric oncology care. Embedded pediatric palliative care (PPC) is relatively new in pediatric hematology/oncology (PHO) and may improve access, utilization, and quality of PPC. In June 2020, the Mayo Clinic PPC service transitioned from an afternoon, physically independent clinic to an all-day clinic embedded within PHO. Method(s): Retrospective chart review was used to quantify consultation rates from PHO to PPC in 12-month study periods before and after establishment of an embedded clinic. Changes in descriptive statistics and consult patterns were calculated. Study periods were compared using either chi-square or Fisher's exact tests for categorical variables and Wilcox rank sum tests for continuous variables. Result(s): There was an 89% increase in consultations from PHO to PPC after initiation of an embedded clinic (n = 20 vs. n = 38 per 12 months). The absolute number of completed outpatient consults increased from three (15% of visits) pre-embedment to fourteen (37%) post-embedment (p =.082). The median number of days from first oncology visit to PPC assessment was unchanged after embedment (36 vs. 47 days, p =.98). Consults for solid tumors increased from 22% (n = 4) pre-embedment to 60% (n = 18) post-embedment (p <.05). Consults for symptom management increased from 60% (n = 12) to 87% (n = 33) (p <.05). Conclusion(s): Embedment of PPC into a PHO workspace was associated with an increased number of total consults, outpatient consults, solid tumor consults, and consults for symptom management. Our "partial-PPO" model allowed for provision of PPC in the outpatient oncology setting in a clinic where there is not enough volume to support a full-time oncology-focused clinician team.Copyright © 2023 Wiley Periodicals LLC.

Rights

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Citation List Month

2023 SE3 - Oncology

Citation

Greenmyer JR; Ngo T; Smith M; Collura C; Schiltz B; McCarthy SR, “Consultation patterns before and after embedding pediatric palliative care into a pediatric hematology/oncology clinic,” Pediatric Palliative Care Library, accessed May 30, 2024, https://pedpalascnetlibrary.omeka.net/items/show/19368.