A quality improvement approach to oncologist referrals for hospice care.
A quality improvement approach to oncologist referrals for hospice care.
复制标题
肿瘤科医生转诊临终关怀的质量改进方法。
DOI：
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复制
发表时间：
2016
影响因子：
45.3
通讯作者：
C. Gunten
中科院分区：
文献类型：
--
作者：
C. Gunten
45背景：癌症患者在家庭安宁疗护中经常经历短时间的服务。
45 Background: Cancer patients frequently experience short lengths of service in home hospice care.
METHODS
The Oncology Clinical Guidance Council, composed of medical, surgical, gynecological and radiation oncologists sets standards of care for the OhioHealth system serving central Ohio. The Council was polled for consensus on how long a cancer patient should be enrolled in hospice care. Then, median length of stay of patients referred by 18 medical oncologists from their offices to OhioHealth hospice for calendar year 2014 were obtained. A letter from the Chairs of the Oncology Clinical Guidancee Council was sent to each medical oncologist noting the council's opinion about optimal length of stay, the length of stay reported by the National Hospice and Palliative Care Organization (NHPCO), and the median length of stay of all patients referred by OhioHealth oncologists. A chart graphing the median length of stay by oncologist, indicating the name of the oncologist to which the letter was directed, was mailed to each oncologist. One year later, for calendar year 2015, the measurement of median length of stay by oncologist was repeated.
RESULTS
64% of the Oncology Clinical Guidance Council members polled think the median length-of-service for hospice care for cancer patients should be 90 days (3 months) and 20% think it should be 45 days (6 weeks). The NHPCO national median is 43 days. At baseline, the median length of stay for 176 cancer patients referred in calendar 2014 was 19.7 days. The median length of stay for 133 patients referred in the first 10 months of 2015 was 39.6 days.
CONCLUSIONS
A simple quality improvement approach to improving hospice length of service by oncologists yielded a doubling to reach the national median in one year.