Integration of palliative care (PC) in oncology requires changes in delivery and processes of care, such as implementation of comprehensive, evidence-based interdisciplinary plans of care (IPOCs). A multidisciplinary design team partnered with an electronic health record company and an information analytics company that specializes in online clinical practice guidelines. The team sought to develop electronic IPOCs that address the unique needs of oncology inpatients, attend to PC needs, and reflect the interdisciplinary team’s contribution to quality patient outcomes. Our cancer center had paper-based care plans that were not well integrated into workflow, did not represent comprehensive PC, did not reflect interdisciplinary care, and did not guide evidence-based practice at point of care. The team designed IPOCs to be incorporated into each discipline’s workflow and unique documentation and established clinical decision support tools to suggest appropriate IPOCs. Thirty-five IPOCs were developed and included all domains of quality PC. Evaluation of IPOC use indicated incomplete, but improving, adoption of PC-specific IPOCs with engagement in collaborative care planning by a variety of disciplines and across oncology nursing subspecialties.
Sarah Thirlwell, MSc, MSc(A), RN, CHPN, AOCNS, is supportive care director, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Tina M. Mason, MSN, ARNP, AOCN, AOCNS, is nurse researcher, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Donna Davis, BSN, RN, is clinical informatics analyst, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Tamara P. Machowski, BSN, MPH, RN, OCN, is registered nurse III/clinical leader, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Address correspondence to Sarah Thirlwell, MSc, MSc(A), RN, CHPN, AOCNS, H. Lee Moffitt Cancer Center & Research Institute, 12902 Magnolia Dr, MRC-SCM, Tampa, FL 33612 (Sarah.Thirlwell@Moffitt.org).
The authors have no conflicts of interest to disclose.
The authors take full responsibility for the content of this article. The authors did not receive honoraria for this work. No financial relationships relevant to the content of this article have been disclosed by the authors or editorial staff.