| Description |
Background: Palliative care provides specialized medical support for patients with serious illnesses, focusing on symptom management, emotional well-being, and advanced care planning. Despite its benefits, palliative care is often underutilized, particularly in smaller facilities that lack specialized services. Patients with hematological malignancies frequently experience long-term complications that impact their quality of life. However, access to palliative care for these patients remains limited, leading to unmet symptom management needs and increased psychological distress. Local Problem: Within the studied healthcare facility, a lack of access to palliative care services was identified as a significant gap in patient care. Staff reported delays in consultations, with some patients waiting weeks to months from referral. Additionally, palliative care was not available on-site, further delaying symptom management. The absences of these services negatively affect oncology patients, particularly those with hematological malignancies, as well as individuals with other chronic illnesses. This gap in care highlighted the urgent need for a structured needs assessment to evaluate the feasibility of integrating palliative care services within the facility. Methods: A needs assessment was conducted within a large integrated healthcare system in the Intermountain West, focusing on a hospital specializing in oncological care. Interventions: A multidisciplinary team guided the project. The objective was to evaluate the need for expanded palliative care services to improve patient and provider outcomes. A structured needs assessment employed a SWOT analysis, stakeholder interviews, and retrospective electronic health record (EHR) reviews. Semi-structured discussions with stakeholders identified current palliative care processes, barriers, and potential areas for improvement. A retrospective chart review analyzed patient demographics, diagnoses, and referral trends over six months to assess unmet palliative care needs. Quantitative data were analyzed using descriptive statistics, while qualitative data underwent content analysis to identify key themes. Findings were synthesized into an executive summary, budget proposal, and stakeholder presentations, including recommendations for palliative care expansion. Results informed system-wide decision-making on palliative care integration's feasibility, usability, and satisfaction. Results: A retrospective EHR chart review of 88 newly admitted oncology patients from June to November 2024 identified leukemia (67; 76.1%), lymphoma (17; 19.3%), and multiple myeloma (4; 4.5%) as primary diagnoses. Most patients were White (79.5%), followed by Hispanic (14.8%). The largest age group was 70-79 (26.1%), followed by 60-69 (23.9%). Despite these complexities, only one patient (1.1%) received a palliative care referral, highlighting a significant gap in service utilization. A SWOT analysis and semi-structured discussions with healthcare staff (n=47) identified organizational strengths (high-quality, patient-centered care) and weaknesses (resource limitations, workflow inefficiencies). Conclusion: This needs assessment identified a critical gap in palliative care referral and utilization despite the complexity of patient care. Findings demonstrate that early palliative care integration is feasible and beneficial with strong stakeholder support. However, key barriers must be addressed to ensure successful implementation, including resource constraints, workflow adaptation, and staff resistance. The following steps involve hiring a palliative care specialist, developing staff training programs, and refining referral workflows to improve accessibility and patient outcomes. |
