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Delivering Palliative Care to Hospitalized Oncology Patients: A Scoping Review

  • Author Footnotes
    # Co-First Authors.
    Harry J. Han
    Correspondence
    Address correspondence to: Harry J. Han, MD, Section of Palliative Care, Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, E/Yamins 100, Boston, MA 02215 USA.
    Footnotes
    # Co-First Authors.
    Affiliations
    Section of Palliative Care, Division of General Medicine and Primary Care (H.J.H., J.C.Y.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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  • Author Footnotes
    # Co-First Authors.
    Jonathan C. Yeh
    Footnotes
    # Co-First Authors.
    Affiliations
    Section of Palliative Care, Division of General Medicine and Primary Care (H.J.H., J.C.Y.), Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
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  • Megan McNichol
    Affiliations
    Division of Knowledge Services, Department of Information Services (M.M.), Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
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  • Mary K. Buss
    Affiliations
    Division of Palliative Care, Department of Medicine (M.K.B.), Tufts University School of Medicine, Boston, Massachusetts, USA
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  • Author Footnotes
    # Co-First Authors.

      Abstract

      Context

      Early, longitudinal integration of palliative care (PC) is recommended for patients with advanced cancer, in both inpatient and outpatient settings. Despite the growth of specialty PC teams in the last decade, the majority of PC is still delivered in the inpatient setting using a traditional referral-based consult delivery model. However, traditional consultation can lead to significant variation or delay in inpatient PC utilization. New care delivery models and strategies are emerging to deliver PC to hospitalized oncology patients who would most benefit from their services and to better align with professional society recommendations.

      Objectives

      To identify different care models to deliver PC to ho`spitalized oncology patients and summarize their impact on patient and health system-related outcomes.

      Methods

      We conducted a scoping review of peer-reviewed articles from 2006 to 2021 evaluating delivery of PC to oncology patients in acute inpatient care. We abstracted study characteristics, the study's intervention and comparison arms, and outcomes related to specialty PC intervention.

      Results

      We identified four delivery models that have been reported to deliver PC: 1) traditional referral-based consultation, 2) criterion-based or “triggered” consultation, 3) co-rounding with primary inpatient team, and 4) PC clinicians serving as the primary team. We summarize the known outcomes data from each model, and compare the benefits and limitations of each model.

      Conclusion

      Our findings provide guidance to health systems about care delivery models to deploy and implement inpatient PC resources to best serve their unique populations.

      Key Words

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