Developing a “toolkit” to measure implementation of concurrent palliative care in rural community cancer centers

Despite national guidelines recommending early concurrent palliative care for individuals newly diagnosed with metastatic cancer, few community cancer centers, especially those in underserved rural areas do so. We are implementing an early concurrent palliative care model, ENABLE (Educate, Nurture,...

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Bibliographic Details
Published in:Palliative & supportive care 2018-02, Vol.16 (1), p.60-72
Main Authors: Zubkoff, Lisa, Dionne-Odom, J. Nicholas, Pisu, Maria, Babu, Dilip, Akyar, Imatullah, Smith, Tasha, Mancarella, Gisella A., Gansauer, Lucy, Sullivan, Margaret Murray, Swetz, Keith M., Azuero, Andres, Bakitas, Marie A.
Format: Article
Language:English
Subjects:
Caregivers
Collaboration
Hospice care
Lung cancer
Nursing
Oncology
Organizational change
Original Articles
Palliative care
Patients
Peer tutoring
Quality of life
Rural health care
Veterans
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Summary:Despite national guidelines recommending early concurrent palliative care for individuals newly diagnosed with metastatic cancer, few community cancer centers, especially those in underserved rural areas do so. We are implementing an early concurrent palliative care model, ENABLE (Educate, Nurture, Advise, Before Life Ends) in four, rural-serving community cancer centers. Our objective was to develop a "toolkit" to assist community cancer centers that wish to integrate early palliative care for patients with newly diagnosed advanced cancer and their family caregivers. Guided by the RE-AIM (Reach, Effectiveness-Adoption, Implementation, Maintenance) framework, we undertook an instrument-development process based on the literature, expert and site stakeholder review and feedback, and pilot testing during site visits. We developed four instruments to measure ENABLE implementation: (1) the ENABLE RE-AIM Self-Assessment Tool to assess reach, adoption, implementation, and maintenance; (2) the ENABLE General Organizational Index to assess institutional implementation; (3) an Implementation Costs Tool; and (4) an Oncology Clinicians' Perceptions of Early Concurrent Oncology Palliative Care survey. We developed four measures to determine early palliative care implementation. These measures have been pilot-tested, and will be integrated into a comprehensive "toolkit" to assist community cancer centers to measure implementation outcomes. We describe the lessons learned and recommend strategies for promoting long-term program sustainability.
ISSN:1478-9515
1478-9523
DOI:10.1017/S1478951517000323