Survey of oncology clinicians to identify barriers to PPC involvement
Members of the project team (OO, SF, KL) developed a 6-question, short answer survey which was emailed to all hematology oncology attendings, fellows, social workers, and APRNs assessing barriers to PPC involvement in pediatric oncology patients. The survey response rate was 65% (n= 76).Identified barriers included concerns that a patient and family may have a negative view of palliative care which would adversely affect the relationship with the oncology team, concerns for potential communication issues, uncertainty about the right time to consult PPC, lack of clarity regarding palliative care roles, and fear that PPC involvement would be a burden to the family. Almost half (47%) of respondents felt that all patients with a 5-year EFS of < 50% at diagnosis should have PPC consulted at time of diagnosis, and more than half (59%) felt that PPC should be involved at the time of relapse or discussion of refractory disease. Based on these responses, the study team created a key driver diagram (Figure 1)