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%.