A Process Evaluation of an Outpatient Palliative Care Program

Palliative care has evolved from providing care for patients near end of life into a specialized discipline focused on addressing the physical, emotional, social, and spiritual needs of patients throughout the trajectory of an illness. For patients with metastatic cancer, timely referrals to palliative care are essential in order to have a meaningful impact on their quality of life. Recommendations for screening patients for palliative care have been offered by professional organizations; however, screening all patients with metastatic cancer poses many challenges. This quality improvement project conducted a process evaluation of an outpatient palliative care program and evaluated the feasibility of utilizing a screening tool in an effort to readily identify patients with metastatic cancer who have palliative care needs in an outpatient cancer center. Although nurses' compliance with the screening tool was less than expected, screening for palliative care needs in this setting resulted in more referrals to palliative care compared with physician referrals. Improvements in quality of life were found in patients who received a palliative care consultation, and patients were very satisfied with the care provided by palliative care. The potential for financial improvements was observed as a result of this project.