A new collaborative model in cancer care developed by doctors at Duke University Hospital (NC, USA) has resulted in a reduced rate of admission of patients to intensive care, or readmission to the hospital after discharge. Researchers from Duke University presented their findings at the Palliative Care in Oncology Symposium (held 24–25 October 2014 Boston, MA, USA).
The new model in cancer care aims at delivering care to patients admitted to Duke University Hospital via a ‘co-rounding’ format. With the aim of increasing collaboration and communication medical oncologists and palliative care physicians met several times a day to discuss patient’s care.
“The integration of palliative care, as a necessary and essential component of cancer care, is one that has been increasingly endorsed,” commented Richard Riedel (Duke University Hospital), the lead author of the study. “The benefits of palliative care have been shown in the outpatient and consultative settings, but we didn’t know its impact on daily inpatient care. Now, we have successfully partnered with our palliative care colleagues to bring their unique skill sets and expertise directly to our admitted patients, and have shown it to be beneficial.”
The study reviewed 2353 inpatient encounters that involved alleviation of pain, side effects and improvement of quality of life. The results demonstrated that that the incorporation of palliative care soon after a cancer diagnosis rather than once the disease had progressed led to a 23% decrease in hospital readmissions within a week of initial discharge. This integration also resulted in a 15% decrease in intensive care transfers, and patients were discharged from the hospital an average of 8 hours sooner. During this time, hospice referrals were seen to increase by 17%.
To the best of the researchers’ knowledge, no other institution has implemented a similar co-rounding approach, and Duke University Hospital has also now established new outpatient care clinics in oncology and general medicine. The researchers also hope to take the findings of this study even further, including carrying out an in-depth cost–benefit analysis.