MASSC Survey - PowerPoint PPT Presentation

1 / 44
About This Presentation
Title:

MASSC Survey

Description:

Dedicated palliative care grand rounds Results A little over 1/2 the ... what proportion of patients seen by palliative care belong to the pediatric age group ... – PowerPoint PPT presentation

Number of Views:236
Avg rating:3.0/5.0
Slides: 45
Provided by: Lando84
Category:

less

Transcript and Presenter's Notes

Title: MASSC Survey


1
MASSC Survey Program Leaders
Mellar P. Davis M.D. FCCP FAAHPM
2
Format
  • Questions 4-25, 39, 44, 49, 51, 54-60, 62-65
    pertain to all programs.
  • Questions 26-38 pertain to programs with
    dedicated (non-hospice) acute care beds.
  • Questions 40-43 pertain to programs with a
    dedicated consultation service.
  • Questions 45-48 pertain to programs that see
    patients in an outpatient setting

3
Format
  • Question 50 pertains to programs that have a
    hospice program.
  • Questions 52-53 pertain to programs with
    palliative medicine fellowship programs.
  • Question 61 pertains to programs that have
    palliative care grand rounds.
  • Questions 66-81 pertain to programs that have a
    research program. Note that questions 76-81
    appear to pertain to all programs however
    question 65 ends the survey if the program does
    not conduct research.

4
Results
  • 62 program leaders completed the survey
  • Program names were most often described using a
    single phrase (Question 2) Palliative care,
    22/61 (36)
  • Comprehensive cancer care, 5/61 (8)
  • Pain and symptom management, 3/61 (3)
  • Supportive care 2/61 (3)
  • An unlisted phrase,5/61 (8)
  • 39 of programs were described using two or more
    phrases

5
Results
  • The majority of programs were recorded as being
    more than five years old (43/61, 70) 3 (5)
    were recorded as being less than one year old 4
    (7) as being 1-2 years old, and 11 (18) as
    being 3-5 years old.
  • Responses are reported for all leaders combined
    and broken down by whether the program is
    relatively new (lt5 years old) or mature (gt5 years
    old).

6
What are the specific kinds of palliative care
services that are available? What are the type
(s) of services that your palliative care team
offers?
7
Results
  • Other than in-house hospice the majority of
    programs offer all of the services described in
    questions 4 and 5, with 49 of programs offering
    consultation/mobile team service, supportive care
    clinics, and dedicated PC acute care beds (Q4)
    59 of programs offered 7-8 of the specific
    services listed in Q5

8
Approximately, what proportion of patients seen
by palliative care belong to the pediatric age
group (lt18 year old)?
9
Results
  • Approximately 1/3 (34) of programs see pediatric
    patients

10
What is the professional background of the
palliative care program leader?
11
Results
  • The professional background of program leaders is
    quite varied. The most commonly recorded
    specialty was medical oncology (74). 69 of
    respondents recorded gt1 specialty

12
Within your program, please indicate the
approximate number of paid personnel assigned to
palliative care
13
Results
  • 48 of programs reported having gt5 ward
    (inpatient) nurses assigned to PC 10 reported
    having gt5 clinic (outpatient) nurses assigned to
    PC
  • The majority of programs have at least one
    chaplain, dietitian, mid-level provider,
    rehabilitation personnel, psychologist, and
    social worker assigned to PC, but no pharmacists
    or psychiatrists

14
Approximately, how many full-time equivalent
(FTE) physician positions are available in your
palliative care program?
Approximately, how many physicians on your
palliative care team have at least 20 academic
protected time?
Does your palliative care program require
physicians to be certified (finished a fellowship
and taken boards)?
Does your palliative care program require nurses
to be certified (taken boards in palliative
nursing)?
15
Results
  • Programs reported a median (range) of 2 (0-15)
    FTE physicians available for PC over half (55)
    the programs reported that at least some
    physicians have gt20 academic protected time
  • The majority of programs (58) required
    physicians to be certified (finished a fellowship
    and passed boards) and 53 required nurses to be
    certified

16
On average, how long does your palliative care
team follow patients in your institution (all
inpatient and outpatient encounters)?
17
Results
  • 43 of programs followed patients throughout the
    course of their illness

18
Does your palliative care program have any
dedicated acute care beds in your institution
19
Results
  • Almost 3/4 (74) of programs reported having
    dedicated (non-hospice) acute care beds median
    (range) number of beds - 10 (0-43)
  • Almost 3/4 (74) of these programs had a
    designated PC unit
  • Within these programs the median (range) number
    of inpatient discharges/month was 24 (2-250) and
    the median length of stay was 10 days (range
    3-98)

20
Results
  • The median (range) inpatient PC mortality rate
    within these programs was 40 (2-99)
  • Acute symptom management was the primary reason
    for admission. Program leaders reported a median
    of 60 (range 0-90) of admissions were for
    symptom management
  • The primary referral sources were outpatient
    clinics (median 25 range 0-90)), and inpatient
    units other than intensive care (median 20
    range 0-100)

21
Results
  • gt75 of patients received regular psychosocial
    assessments on each admission in 55 of programs
  • gt75 of patients had family conferences in 50
    of the programs
  • Oncologists attended gt75 of family conferences
    in 36 of programs
  • gt75 of patients had standing DNR orders in 51
    of programs

22
Does your palliative care program have a
dedicated consultation service in your
institution?
23
Results
  • The vast majority (92) of programs had dedicated
    consultations services
  • The service was available 24/7 in 43 of programs
  • A median (range) of 25 (3-400) referrals were
    made to the service monthly
  • The most common referral sources were medical and
    radiation oncology, and surgery

24
Does your palliative care program see patients in
the outpatient setting?
25
Results
  • 90 of programs saw patients in an outpatient
    setting (primarily dedicated PC units)
  • Outpatient clinics were held a median (range) of
    5 (0.5-7) days a week and a median (range) of 30
    (3-250) referrals/month were made to it
  • Similar to consultation services the most common
    referral sources were medical and radiation
    oncology, and surgery

26
Does your institution operate a hospice?
27
Results
  • 23 of programs operated a hospice

28
Fellowship program for Palliative Medicine?
29
Results
  • A little over 1/3 (37) of programs had a
    fellowship program for palliative medicine.
  • Most of these programs (52) had 1-2 clinical
    fellows/year 56 had 1-2 research fellows/year

30
Mandatory palliative care rotations for
31
Results
  • When applicable the majority of programs (56)
    required PC rotations for medical oncology and
    hematology fellows
  • 33 required them for radiation oncology
    fellows
  • 9 required them for pediatric oncology fellows
  • 51 required them for other fellows/residents
  • 35 required them for medical students

32
Training of mid-level providers in palliative
care
33
Results
  • Most programs (61) trained mid-level providers

34
Dedicated palliative care grand rounds
35
Results
  • A little over 1/2 the programs (53) held PC
    grand rounds 68 held 1/week and 32 held
    2-3/week

36
Length of training for fellows for certification
37
Results
  • Slightly less than 1/2 the programs (48) had
    recognized accreditation requirements in order to
    be recognized as a PC specialist

38
Is there a research program in palliative care
39
Results
  • 64 of leaders reported having a PC research
    program
  • The research team most frequently consisted of
    physicians (100), data analysts (75), research
    nurses (72), and/or psychologists (56). 44 of
    the teams were fully staffed in the sense that
    they consisted of physicians, data analysts,
    research nurses and psychologists/social workers
    other personnel

40
Results
  • 62 of the research programs received outside
    funding primarily from private foundations and
    philanthropy
  • 86 of programs conducted prospective studies,
    57 conducted retrospective studies, 51 reported
    case series/reports, and 54 conducted
    qualitative studies

41
Results
  • Research programs reported their results in PC
    and oncology journals, as well as more general
    medical journals (70 of programs had at least
    one publication in a PC journal last year 68
    had at least one in an oncology journal and 49
    had at least one in a general medical journal)

42
Young versus Mature Programs
  • The number of newer programs is relatively small
    and therefore comparisons need to be viewed
    cautiously
  • Several differences that are perhaps worth noting
    include

43
Young versus Mature Programs
  • The professional backgrounds of the leaders from
    younger programs tended to be oncology based
    (medical/radiation oncology) more frequently than
    those of mature programs
  • Among programs with dedicated acute care beds
    length of stay tended to be shorter in mature
    programs compared to younger programs (median
    (range) 9.5 (3-96) versus 14.5 (9-98) days,
    respectively, p007)

44
Young versus Mature Programs
  • Among programs with dedicated consultation
    services mature programs tended to have more
    referrals/month than younger programs (median
    (range) 30 (3-400) vs 15 (4-40), respectively,
    p.04) however this may be an artifact of the
    size of the programs?
  • Mature programs tended to require PC rotations
    for non-oncology fellows and residents more
    frequently than younger programs (60 vs 20,
    p.04) however this could be an artifact of the
    type of PC programs in each group?
Write a Comment
User Comments (0)
About PowerShow.com