The Effects of Integrating a Palliative Care Screening Tool at an Outpatient Oncology Clinic to Enhance Understanding and Utilization of Palliative Care Services

Palliative Care services are underutilized in patients who have cancer primarily due to lack of understanding of what it encompasses by both, the patients and providers. The purpose of this quality improvement project was to facilitate Palliative Care referrals by the use of a Palliative Care screening tool: the Edmonton Symptom Assessment Scale with the Canadian problem Checklist and the PCQN Distress Screener. The Representational Approach and Jean Watson’s theory of Unitary Caring were utilized in the teaching moment. The screening tool was implemented at initiation and change of treatment during teaching visits by the nurse practitioners with the goal to increase palliative care referrals by 10% over a 3-month period of time and compared to the previous year. The results indicate that there were more palliative care referrals in the project implementation phase than the control quarter. A Chi Square test of Independence illustrated a statistically significant difference in the number of referrals during the project implementation phase versus the control quarter. The project’s short duration along with seasonal population fluctuations in South Florida limits data comparison to the previous year. A total of 10 palliative care referrals were made by nurse practitioners during the teaching visit in the 12-week project implementation period contributing to 3.5% of all palliative care referrals made. It is recommended that the project continue to provide more points for data analysis and continued patient exposure to palliative care services.