Bridging the Gap: An Evidence-Based Quality Improvement Initiative to Increase Palliative Care Referrals in Primary Care

POSTER

Bridging the Gap: An Evidence-Based Quality Improvement Initiative to Increase Palliative Care Referrals in Primary Care Morgan Rawlings, DNP-S, BSN, RN; Lynn Reinke, APRN; Katherine Doyon, Ph.D., M.Ed., RN., CHPN Key Take Away Primary care providers have the potential to restore patient autonomy to improve quality of life . when referring qualifying patients to palliative care. Background • Less than 1/3 of the U.S adult population knows what palliative care is. • Primary care providers are less likely to have any palliative care training. • Trained PCPs are 5x more likely to engage in GOC conversations than other specialties. • Refugees’ complex health histories and cultural barriers lead to fewer palliative care referrals. Purpose To improve awareness of palliative care and the frequency of palliative care referrals by primary care providers. Pre 120 • Participants: 12 residents, 2 N.P.s, 6 M.Ds Post • 0 referrals to PC 12 months prior to project 100 • 6 referrals to PC 3 months after implementation 80 60 • After toolkit implementation, 100% of PCPs disagreed that PC means death (up from 83.34%) 40 20 0 Knowledge of PC Methods • Guided by PDSA/Johns Hopkins Evidence Based Practice Model • Survey to assess clinician awareness • Toolkit based on literature • Education session based on survey and literature • Created handouts for patients in English, Arabic, and Spanish. • EHR pathway created for PC referrals. Results Pre and Post Intervention Survey Results Confidence in Comfort discussing PC identifying appropriate with patients/families patients for PC (somewhat/very) 94% would recommend this project to others Usability Feasibility 18.5% 14.5% 81.5% Yes No User Satisfaction 23.5% 75.5% Yes No 76.5% Yes No • The toolkit boosted “very familiar” PC ratings by 19.44% Conclusions • When PCPs are aware of PC and how to access PC, referrals increase. • Providing PCPs with tools and resources for PC integration drives sustainable change. • Future initiatives can explore PC approaches for refugees or outpatient PC referrals from the patient perspective.