Implementation and early outcomes of a statewide oncology primary palliative care training program.

Abstract

299 Background: Despite its proven benefits, palliative care remains underutilized in people with cancer due to unequal access, including provider shortages and geographic barriers. The Michigan Oncology Quality Consortium partnered with the Center to Advance Palliative Care to develop a statewide primary palliative care training program for oncology clinicians. The program aimed to improve clinician knowledge and skills, particularly in regions with limited access to palliative care. Methods: The 6-month curriculum combined online self-study courses, learning activities, monthly faculty-led virtual clinical discussions, and a capstone case-study poster presentation. Focus areas included foundations of palliative care, assessment, caregiver support, pain and symptom management, communication skills in serious illness, and prevention of crises and planning ahead in the serious illness trajectory. Pre- and post-program evaluations assessed clinician comfort using survey questions and knowledge via post-test questions. Results: Thirty-four applications were received, and 15 participants were selected from outpatient oncology practices across Michigan, with priority given to those in rural communities. Participants included 8 nurse practitioners, 6 physician associates, and 1 physician in tribal primary care. The proportion of learners reporting they were “very” or “extremely” comfortable improved in all 7 areas topic areas, including discussing cancer diagnoses (pre: 47%; post: 100%), assessing what is important to patients (pre:47%; post: 87%), and discussing care plans (pre: 53%; post: 87%). The greatest increase in comfort was seen in assessing risk of opioid substance use disorder (pre: 7%; post: 67%). For the quiz questions, the proportion of correct responses increased in 7 of the 10 questions. Some of the most notable increases include: Participants reported high program satisfaction: 87% stated the program exceeded expectations, and 100% would recommend the program to colleagues. Qualitative feedback highlighted improved communication skills, greater attention to caregiver needs, and more patient-centered goals-of-care discussions. Conclusions: We demonstrated that a statewide oncology-focused primary palliative care training program is feasible, successful and well received among clinicians. Early findings suggest meaningful improvements in clinician knowledge and comfort with palliative care skills. This may expand primary palliative care capacity, particularly in underserved areas.