SS 10 - Palliative 2
76 - Integrating Radiation Oncology into Inpatient Interdisciplinary Rounds With Medical Oncology and Palliative Care
Monday, October 22
8:45 AM - 8:55 AM
Location: Room 007 C/D
Daniel Mark, MD
North Shore-LIJ Health System: Radiation Oncology Resident: Employee
Integrating Radiation Oncology into Inpatient Interdisciplinary Rounds With Medical Oncology and Palliative Care
D. J. Mark1, P. Gilbo2, S. Joseph1, A. Goenka3, and B. F. Bloom1; 1Department of Radiation Medicine, Hofstra Northwell School of Medicine, Lake Success, NY, 2Department of Radiation Medicine, Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Lake Success, NY, 3Department of Radiation Medicine, Northwell Health, Lake Success, NY
In an academic tertiary care setting, we have developed a multidisciplinary palliative care team, which includes members of radiation oncology, medical oncology, and palliative care, that performs daily inpatient rounds. We look to examine the impact this initiative has had on recommendations for radiation therapy, patient length of stay, and for those patients recommended radiation treatment, treatment completion rates.
Multidisciplinary palliative care rounds (MPCR) were initiated in July 2017. We retrospectively reviewed all medical records for patients treated at this inpatient facility from 1/2017 – 12/2017, and recorded demographic data, treatment details, and length of inpatient stay after a radiation oncology consultation. We compared the 6 month baseline data prior to the initiative (1/17-6/17) with that from the 6 months immediately following (7/17-12/17) using Chi-square and two sample, two tailed t-tests.
176 inpatients received radiation therapy during this 12 month interval. There was a 35% increase in number of inpatient radiation treatment courses in the 6 months after development of MPCR as compared to the 6 months prior (104 treatment courses post-MPCR versus 77 treatment courses pre-MPCR). Number of fractions recommended was not different (mean of 6.1 fractions pre-MPCR versus mean of 5.5 fractions post-MPCR, p=0.37). The median number of fractions recommended for both time periods was 5. There was a trend towards increased recommendation of single fraction RT (7 courses pre-MPCR versus 16 courses post-MPCR, p=0.16). Early treatment terminations, defined as patients who received less than the prescribed number of treatments, was not different (11.7% pre-MPCR versus 13.5% post-MPCR, p=0.72). There was, however, a trend towards decreased length of stay (median of 14 days pre-MPCR versus median of 12 days post-MPCR, p=0.36).
We found that multidisciplinary palliative care rounds are feasible and result in changes in practice patterns of palliative care patients. There was a large increase in the number of patients treated with radiation therapy and a trend towards decreased length of stay. This likely is due to better recognition of indications for palliative radiation therapy as well as improved communication between the treatment teams. While the median number of treatments recommended was 5, we did see a trend toward increased recommendation of single fraction treatments. Longer term follow-up is needed to confirm these findings.
Author Disclosure: D.J. Mark: None. P. Gilbo: None. A. Goenka: Employee; Northwell Health. B.F. Bloom: None.