Integration of oncology and palliative care: setting a benchmark
Integration of oncology and palliative care (PC) should be the standard model of care for patients with advanced cancer. An expert panel developed criteria that constitute integration. This study determined whether the PC service within this Health Service, which is considered to be fully “integrated”, could be benchmarked against these criteria.
A survey was undertaken to determine the perceived level of integration of oncology and palliative care by all health care professionals (HCPs) within our cancer centre. An objective determination of integration was obtained from chart reviews of deceased patients. Integration was defined as >70% of all respondents answered “agree” or “strongly agree” to each indicator and >70% of patient charts supported each criteria.
Thirty-four HCPs participated in the survey (response rate 69%). Over 90% were aware of the outpatient PC clinic, interdisciplinary and consultation team, PC senior leadership, and the acceptance of concurrent anticancer therapy. None of the other criteria met the 70% agreement mark but many respondents lacked the necessary knowledge to respond.
The chart review included 67 patients, 92% of whom were seen by the PC team prior to death. The median time from referral to death was 103 days (range 0–1347). The level of agreement across all criteria was below our predefined definition of integration.
The integration criteria relating to service delivery are medically focused and do not lend themselves to interdisciplinary review. The objective criteria can be audited and serve both as a benchmark and a basis for improvement activities.
KeywordsIntegration Oncology and palliative care Benchmarking Criteria for integration
Compliance with ethical standards
Conflict of interest
Prof Janet Hardy declares that she has sat on medical advisory boards of MundiPharma Pty Ltd. and Menarini Australia Pty Ltd. Any honoraria are directed to charity.
All other authors declare no conflict of interest.
Petra Vayne-Bossert was granted a travel and expense fund by the University Hospital of Geneva for a research fellow year (2015) in Brisbane, Australia.
- 5.(ESMO) ESfMO (2003). Designated centres of integrated oncology and palliative care. InGoogle Scholar
- 7.Ferrell B, Temel JS, Termin S et al (2016) Integration of Palliative Care Into STandard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. Journal of Clinical Oncology EpubGoogle Scholar