There is no standard method for integrating palliative care into outpatient oncology practices, and no examples of how cancer centers are doing it.
The 2016 edition of the Commission on Cancer standard 2.4 states, “Palliative care services are available to patients either on-site or by referral.” Further, clinical organizations like the American Society of Clinical Oncology support the integration of palliative care into the care of “any patient with metastatic cancer and/or high symptom burden.” This article will present, as a case study, one program’s integration of palliative care services into outpatient community oncology.
Although the physicians were familiar with the palliative care advanced practice registered nurse (APRN) from the inpatient service, they still expressed concern and had some misunderstanding regarding the role of palliative care.
There was concern that the palliative care team would tell patients they were dying before the patients were ready to discuss death.
Initially, patients were seen bythe palliative care service while they were an inpatient and were subsequently seen in the outpatient oncology office for follow-up care.
This was a good way to start to get to know the practice and team members and begin to gain trust.
In 2013, the palliative care team and the community cancer center decided to explore the trial integration of palliative care into the outpatient oncology practice.
Designated cancer centers tend to have more robust palliative care service but largely use consulting services to provide their palliative care.
The medical students’ interest in case studies used as an instructional strategy in modern medical education and in teaching tools like virtual patients and simulations is growing.
Professional skills and knowledge about palliative care are widely accepted to be deficient and the medical care in palliative care settings remains inadequate.