Early Integration of Palliative Care in Patients with Pancreatic Cancer: A Quality Improvement Project

Files

dnp_capstone_nina_grenon_2013_final (1).pdf

Citation

Grenon, Nina N., “Early Integration of Palliative Care in Patients with Pancreatic Cancer: A Quality Improvement Project,” Scholar@Simmons, accessed January 16, 2021, http://beatleyweb.simmons.edu/scholar/items/show/201.

Title

Early Integration of Palliative Care in Patients with Pancreatic Cancer: A Quality Improvement Project

Creator

Grenon, Nina N.

Date

2013

Description

Many patients with pancreatic cancer receive palliative care only at the end of life, despite the fact that for most patients the entire course of the illness is plagued with physical and emotional symptoms and related distress even during active treatment. The evidence suggests that late referrals to palliative care are insufficient to alter patients’ quality of life (QOL). There is strong evidence demonstrating that people with metastatic cancer benefit with improved QOL when palliative care is combined with standard cancer treatment and in some situations life may even be extended. Early integration of palliative care to improve the QOL for patients with an incurable cancer such as pancreatic cancer is an important focus for quality improvement.
The purpose of this study was to identify the quality indicators for palliative care, and examine when during the course of the illness palliative care was introduced in patients with pancreatic cancer. An abstraction instrument was developed for this study; content validity and inter-rater reliability was established in a pilot study of 15 MR. A retrospective medical record (MR) review was conducted of 150 randomly sampled records of patients with pancreatic cancer treated at the Dana-Farber Cancer Institute (DFCI) during a 3 year period. Domains of palliative care identified by the National Consensus Project (NCP) and the National Quality Framework (NQF) provided the framework for this study to identify the quality indicators (QI).
Findings from this study show that most patients with pancreatic cancer are not referred to PC until they experience severe and clinically significant symptoms. The majority of patients were referred late in the course of the illness; early integration of PC is infrequent. A number of QI were identified and will subsequently be utilized for future quality improvement in the delivery of PC at the DFCI.

Publisher

Simmons College (Boston, Mass.)

Format

1 PDF (173 Pages)

Language

English

Type

Doctoral Dissertations