Embedded Palliative Care in an Academic Medical Center

Topic: Palliative Care Models by Setting

Cancer patients and their caregivers are often burdened by multiple medical appointments each month. Although they may be receptive to the type of added support provided by outpatient palliative care providers, the addition of another appointment is too overwhelming.  When forced with spreading limited resources of transportation costs, child care and missed work, patients often choose to forego outpatient palliative care appointments.

In our cancer center at the University of Kansas Health System, the Outpatient Palliative Care practice explored if seeing patients during other scheduled appointments would effectively reduce the barriers to patients taking advantage of their services. Working with the cancer center administration, our practice proposed coordinating and embedding palliative care visits with medical oncologist visits and treatment appointments.  Our goal was to increase patients’ willingness to schedule palliative care appointments, and decrease no-show appointment rates, while reducing the schedule strain on patients and caregivers.

 Over the three year period of our outpatient palliative care program, we have found patients much more willing to schedule appointments that are coordinated with other cancer center visits.  The no-show rate among embedded appointments was minimized with patient and staff education.  In addition to achieving our original goal, we have discovered several additional benefits to embedded palliative care appointments.  Providers and patients have benefited from shared knowledge, improved communication and trust building, resulting in more effective therapeutic relationships for all parties.

Author

  • Amy Velasquez, RN
  • Palliative Care Nurse Navigator
  • The University Of Kansas Health Systems
  • 2330 Shawnee Mission Parkway
  • Westwood, KS 66205
  • 913-588-5720

Co-authors

  • Christian Sinclair, MD, FAAHPM
  • Karin Porter-Williamson, MD, FAAHPM
  • Wendy Thomas, RN, MSN, OCN

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