Regional engagement to define, report, and use quality metrics to improve palliative care in oncology.

Authors

null

Kristine Stickney

Fred Hutchinson Cancer Research Center, Seattle, WA

Kristine Stickney, Karma Kreizenbeck, Catherine R. Fedorenko, Bernardo Goulart, Veena Shankaran, J. Randall Curtis, Gary H. Lyman, Csaba Mera, Bruce Smith, Scott David Ramsey

Organizations

Fred Hutchinson Cancer Research Center, Seattle, WA, Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Research Center, Seattle, WA, University of Washington, Seattle, WA, Cambia Palliative Care Center of Excellence at UW Medicine, Seattle, WA, Cambia Health Solutions/Regence BlueCross BlueShield of Oregon, Portland, OR, Regence, Seattle, WA

Research Funding

No funding sources reported

Background: Palliative care in oncology encompasses a wide array of care, and optimal performance metrics remain uncertain. To address this issue we held a regional meeting that included patient advocates, clinicians, private and public payers and researchers to identify quality indicators for palliative care, discuss palliative care (PC) quality measurement in the region, review preliminary results and metrics for PC, and identify opportunities to improve care. Methods: Regional experts facilitated discussions. Data was presented from a regional insurance claims-cancer registry linked database. Participants were asked to: discuss and prioritize interventions to improve palliative care in oncology and create metric dashboards for healthcare providers. Results: Oncology-specific recommendations for interventions: early and continuous palliative care discussions from diagnosis through EOL; training existing care team on palliative care conversations, through standard certification programs; pair patients with an experienced patient/patient advocate; educate caregivers, patients and providers respectively on how to communicate about PC and care choices; and patient navigation to manage symptoms of advanced cancer. Feedback on prioritization of palliative care/EOL metrics: see Table. Conclusions: A multi-stakeholder approach can be effective for developing metrics and interventions to improve palliative care by providing an understanding of the information needs of the community.

StakeholderMetric/data needsConcerns/considerations
for metric development
Patients/advocatesTools/information to manage patient
family relationships and insure patient
preferences are honored
Metrics should lead to solutions that are flexible,
secure and available
PayersPatient Reported Outcomes (PRO)Reliable measures of patient comfort and QOL
AdministratorsAdvanced Directives (ADs) and PROsNeed outcome measures: was pain managed,
AD followed
CliniciansPROs, ADs, rates of readmissions and ED visits,
and costs of care
Both qualitative and quantitative data important
IT professionalsADsDifficulty collecting metrics beyond existing quality
reporting requirements

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Abstract Details

Meeting

2016 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B: Science of Quality

Track

Cost, Value, and Policy in Quality,Practice of Quality,Science of Quality

Sub Track

Quality Measurement

Citation

J Clin Oncol 34, 2016 (suppl 7S; abstr 282)

DOI

10.1200/jco.2016.34.7_suppl.282

Abstract #

282

Poster Bd #

L10

Abstract Disclosures

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