To address the complex care needs of patients with advanced cancer, palliative care is needed. Palliative care emphasizes medically appropriate goal setting, open communication with patients and families, and meticulous symptom assessment and control. Research from AHRQ and others indicates that palliative care interventions are successful in improving patient quality of life, reducing symptoms, improving satisfaction, and reducing caregiver stress. Despite a strong evidence base, research shows that suboptimal delivery of palliative care persists; patients with advanced cancer have multiple unaddressed and uncontrolled symptoms, and unmet psychosocial needs. Results from the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) demonstrate the need for improvement in the outpatient oncology setting. As the leading medical specialty society in oncology, ASCO is uniquely positioned to disseminate evidence-based palliative care tools and resources to practicing oncologists. ASCO proposes development of an innovative strategy to disseminate palliative care research, in collaboration with the American Academy of Hospice and Palliative Medicine (AAHPM). The technology-based dissemination model integrates principles from collaborative quality improvement models. ASCO and AAHPM, along with the research team from Duke University, bring to this effort combined expertise in applied research, education, quality improvement, oncology, and palliative care. The long-term goal of this effort is to create a sustainable, scalable infrastrucure that will facilitate dissemination of palliative care research to multiple provider groups, and dissemination of patient-centered outcomes research results in other clinical areas.
The specific aims of this proposal are:
Aim 1 : Develop the ASCO Virtual Learning Collaborative (VLC) to disseminate evidence-based solutions to support primary palliative care in oncology. The VLC will include a coordinated, customized suite of virtual learning modules, social networking/media, resource sharing, and webinar functionality adapted from existing ASCO technology solutions, and a toolbox of evidence-based resources.
Aim 2 : Pilot test, refine, and launch the ASCO Virtual Learning Collaborative. Teams from oncology practices will utilize the VLC to inform and support local tests of change using Plan-Do-Study-Act cycles. Teams will share best practices and resources through the VLC, benefiting from expert and peer guidance. We will utilize the RE-AIM framework to evaluate the pilot, including the impact of the VLC on quality measure performance related to primary palliative care; and the adoption and implementation of the VLC platform using usage data, surveys, interviews and focus groups. The palliative care toolbox will be widely available for use by oncologists and other disciplines. f supported by the pilot, the VLC will be launched for ASCO membership use.
Despite a strong evidence base for effective palliative care interventions from research by AHRQ and others, studies show that palliative care is suboptimal for patients with advanced cancers. The ASCO Virtual Learning Collaborative (VLC) will provide an innovative and feasible dissemination strategy for research that requires complex, system-level change. We propose to develop, pilot test, and refine the VLC platform and evidence-based toolkit for launch.
