SPCR-10 Cancer Co-Rounds: A Novel Inpatient Multidisciplinary Oncology Rounding Model

Abstract

BACKGROUND Although tumor boards are well-established for coordinating care of patients with cancer in the outpatient setting, few studies have evaluated interventions for improving consultative care coordination for hospitalized patients. This study evaluated the hypothesis that implementation of an inpatient co-rounding model of care including medical-, neuro-, and radiation-oncology consult teams would improve the alignment of recommendations from these oncologic services, as perceived by primary teams. METHODS A co-rounding model was implemented in September 2021 for hospitalized patients with cancer at a tertiary medical center. The oncologic consulting services met virtually twice weekly to discuss patient care. Providers from the most common primary services for patients with cancer, internal medicine (IM) and neurosurgery, were surveyed via institutional email listservs. The survey included Likert-type questions about the alignment of recommendations across services and open-ended questions for feedback on collaboration among these services. Pre-intervention surveys were distributed, and post-intervention surveys were distributed 9 months later. Wilcoxon rank-sum tests were used to compare responses pre- and post-intervention. RESULTS At each session, a median of 6 providers attended (range, 4-8 providers), and a median of 6 patients were discussed (range, 4-8 patients). Of the 331 providers surveyed, there were 119 (36%) respondents pre-intervention and 34 (10%) respondents post-intervention. The 132 unique respondents comprised 68 (52%) IM attending physicians, 48 (36%) IM resident physicians, 6 (5%) neurosurgery advanced practice providers, 6 (5%) neurosurgery attendings, and 4 (3%) neurosurgery residents. Post-intervention, respondents were significantly more likely to perceive alignment in oncologic consultant recommendations (67% strongly agree) compared to pre-intervention (23% strongly agree, p<0.01). CONCLUSIONS A novel inpatient co-rounding model was successfully implemented between medical-, neuro-, and radiation-oncology. Primary teams perceived greater alignment in recommendations among these consulting services after implementation. Future directions include evaluation of the impact of this model on patient outcomes.