Training Mid-level Providers on Palliative Care

Abstract

Palliative care services are not available in most outpatient oncology practices. A program training 11 mid-level providers from oncology practices on advanced directive discussions and supportive symptom assessment and management performed by palliative care specialists was completed. A follow-up session 9 months later identified barriers to implementation. Of the 11 mid-level providers, 8 participated in the follow-up session, and 9 of the 11 providers implemented advanced directive’s discussions and symptom assessment and management for patients with metastatic cancer. Main barriers included uncertainties about reimbursement, patients’ lack of knowledge about palliative care, and lack of access to supportive services. This program successfully promoted advanced directive discussions and supportive/palliative care symptom assessment and management to community oncology practices, which will hopefully translate into improved quality of life for patients with metastatic cancer.

Cancer rehabilitation and palliative care: critical components in the delivery of high-quality oncology services

“…However, opportunities do exist to improve the delivery of supportive cancer care. In fact, studies have demonstrated that mid-level providers, after brief training, have been able to successfully screen patients for symptom burden and discuss end of life care [86], and should therefore be integrated into care programs. Trainees, including medical students, must have increased instruction in palliative and rehabilitation care.…”

Culturally Adapting an Advance Care Planning Communication Intervention With American Indian and Alaska Native People in Primary Care

“…Earlier efforts to improve ACP focused on training nurses and other providers to have the knowledge, tools, and skills to initiate conversations about ACP (Lesperance et al, 2014). Curtis et al’s (2018) intervention expanded previous efforts by providing an individualized, patient-centered tool that prepares patients and their families (or other caregivers) to initiate conversations about ACP, thereby enabling patients to participate more actively and equally in communication and decisions about their health care.…”

Promoting Advance Directives and Ethical Wills With the HIV-Aging Cohort by First Assessing Clinician Knowledge and Comfort Level

“…Patient-related barriers occurred when the patient felt that engaging in such discussions was giving up hope; practice-related barriers were the lack of dedicated time for engaging in the conversation, and there were questionable reimbursement issues (Lesperance et al, 2014).…”

“…Clinician education and utilization of AD were illustrated in a study by Lesperance et al (2014). The main purpose of the study was to increase the knowledge of advanced practice nurses, physician assistants, and licensed clinical social workers on best practices related to the Five Wishes document in an oncology practice setting.…”