title: Implementation of NCCN Palliative Care Guidelines by member institutions.
abstract: Increasingly, evidence suggests the integration of palliative care (PC) with standard oncologic care can yield substantial benefits. As part of an effort to improve the PC of cancer patients, the National Comprehensive Cancer Network (NCCN) has developed clinical practice guidelines for PC that promote access to quality, evidence-based PC. This study sought to characterize current implementation of the guidelines by NCCN member institutions. Institutional representatives appointed to the NCCN Palliative Care Guidelines Panel were asked to complete an online survey in the spring of 2014. The survey focused on availability of PC services, screening and referral practices for PC, PC education, and quality improvement programs. The survey was completed by representatives from 21 of 25 NCCN member institutions (84 %). A majority routinely provides PC services via interdisciplinary teams; 52 % routinely inform patients of the availability, elements, and benefits of PC. The guidelines are most often used to guide clinical practice; only 10 % reported using the guidelines to formally screen for PC needs and/or make referrals to PC specialists. Among the 62 % of institutions that screen any patients using any available criteria, when a patient screens positive for PC needs, a referral to a PC specialist is made less than half the time. Implementation of PC Guidelines is incomplete and various aspects of the guidelines, such as the recommendation to screen all patients for PC needs, are applied inconsistently. Despite this, most institutions provide PC services in a manner consistent with the guidelines. Greater implementation of the guidelines' recommendations is needed.
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, MRC-SCM, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Albizu-Rivera
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, MRC-SCM, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
authors.forename: Diane G
authors.initials: DG
authors.lastname: Portman
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, MRC-SCM, 12902 Magnolia Drive, Tampa, FL, 33612, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Thirlwell
authors.affiliation: Emory University Hospital, Atlanta, GA, USA.
authors.forename: Shirley N
authors.initials: SN
authors.lastname: Codada
authors.affiliation: H. Lee Moffitt Cancer Center and Research Institute, MRC-SCM, 12902 Magnolia Drive, Tampa, FL, 33612, USA. kristine.donovan@moffitt.org.
authors.forename: Kristine A
authors.initials: KA
authors.lastname: Donovan
mesh_terms: D019983:Guideline Adherence / Q000706:statistics & numerical data*; D017408:Guidelines as Topic; D006801:Humans; D009369:Neoplasms / Q000628:therapy*; D010166:Palliative Care / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012017:Referral and Consultation; D011795:Surveys and Questionnaires
keywords: Clinical practice guidelines; Integration of palliative care; Palliative care