| Description |
The impact of Social Determinants of Health on the well-being and outcomes of oncology patients is amplified for those residing in rural and frontier regions. In 2023, an estimated 52,000 individuals in the Mountain West may receive a cancer diagnosis, with approximately 14,000 cases in Utah alone. While an adapted urban hospital-at-home program has been shown to benefit rural and frontier patients by mitigating hospitalizations and enhancing care outcomes, enrollment remains limited. Local Problem: Rural cancer patients face challenges in accessing healthcare services. These challenges, including low health literacy, poverty, and limited availability of healthcare facilities, result in an increased burden of unplanned emergency department (ED) visits and hospitalizations. Despite the potential for the local hospital-at-home program, Huntsman at Home Rural (HHR) to address these disparities, awareness and enrollment of rural patients in this program remain limited. Methods: A quality improvement project was developed based on current literature and clinician responses to pre-intervention questionnaires about their awareness of the HHR program. Interactive education sessions were conducted to help increase awareness and referrals to the HHR program. Adjustments to the education session were based on ongoing feedback from clinicians. Stakeholder collaboration, a review of recent literature, and an analysis of stakeholder feedback informed methods for increasing enrollment. Demographic data were collected using descriptive statistics. Quick Response (QR) codes and informational flyers were distributed to improve patient and clinician accessibility. Referral rates and missed opportunities were assessed 100 days pre- and post-implementation. Interventions: Use and awareness of the HHR program were assessed by tracking the number of referrals before, during, and after project implementation. Referrals were tracked using the Electronic Health Record. In addition, "missed opportunities" were tracked to evaluate overall compliance and utilization of the program. Simultaneously, discussions with clinicians continued throughout the implementation phase to assess participants' experiences, identifying barriers, facilitators, and enhancement suggestions. A toolkit featuring a QR code, a rural area map, and an informational flyer was distributed to enhance program awareness among clinicians and patients. Awareness of the program and utilization were assessed through pre- and post- intervention questionnaires. Results: The project findings demonstrate a notable impact on referral patterns and healthcare provider awareness. During the 100-day pre-implementation phase, the referral rate was 38.5%, increasing to 87.5% during implementation and 63% post-implementation. This represents a 25% overall change in referral rate. Moreover, healthcare provider familiarity with the referral process significantly improved, with 82% reporting moderate to high familiarity post- implementation compared to 13% pre-implementation. Statistical analysis confirmed the significance of these findings (U=33, p<0.05), affirming the program's positive impact on referral rates and provider awareness. Conclusion: The intervention demonstrated increased utilization, suggesting the project positively influenced referral patterns and heightened provider awareness, signifying its effectiveness and potential impact on rural cancer patient outcomes. |
