Palliative Care Intergration Into an Acute Leukemia and Bone Marrow Transplant Program

Advancements in bone marrow transplant (BMT) have led to an increasing number of patients surviving both their initial cancer diagnosis, and the aggressive treatment used to cure the cancer. However for most patients, this cure comes at a significant cost. Complications from BMT and chemotherapy regimens lead to chronic conditions, which impact both quality and quantity of life. Palliative care is not only for dying patients; It provides support for symptom management, emotional support, and advance care planning for any patient and family member facing serious illness. Most importantly, palliative care improves communication between the primary physician and family members, and assists with sometimes very difficult life questions. Clinical integration of two palliative care MD clinic sessions have been embedded into the BMT clinic workflow in February 2012. The purpose is to measure outcome support for the staff, patient and family members on an outpatient basis and increase palliative care physician referrals from the Bone Marrow Transplant program. In addition, a goal is to increase patient/family and team planning for end of life care and to decrease the number of hospital deaths among Bone marrow Transplant patients. The University of Kansas Outpatient Blood and Marrow Transplant Program has undertaken a Quality Improvement Retrospective Project utilizing Palliative Care in the outpatient setting, to proactively address these chronic issues. Retrospective analysis suggests implementation of early Palliative Care in this patient population improves quality of life, while reducing costly in-patient, end of life care.