Intervention Period
During the intervention period, 6 patients with a target list diagnosis
died while 16 received a new diagnosis of a target list cancer. None of
the patients with a new target list diagnosis died during the
intervention period. Our outcome measure improved from a median of 13.5
days to 159.5 days (Figure 2 ) resulting in an increase from our
baseline of 43% to 100% (n=6) of target list patients receiving PPC
involvement ≥30 days prior to death. Our process measure of time from
target list diagnosis to PPC consult decreased from 221.5 days to 14
days (Figure 3 ) resulting in an increase from our baseline of
28% to 63% (n=10) of patients receiving involvement ≤30 days after
diagnosis.
Of those 6 patients without PPC consult <30 days after
diagnosis, only 17% (n=1) had template note documentation of the
rationale.
Following our interventions, our institution reported to USNWR in 2019
that PPC involvement more than 30 days prior to death in pediatric
oncology patients with refractory cancer occurred in 79% of our
patients surpassing the national benchmark of 75%.