title: Developing a model for embedded palliative care in a cancer clinic.
abstract: OBJECTIVE
  Describe the development and key features of a model for embedded palliative care (PC) for patients with advanced kidney cancer or melanoma seen in a cancer clinic.
  
  
  METHODS
  Retrospective chart review of patients following an initial phase and then a prospective review following the implementation of a model for embedded PC.
  
  
  RESULTS
  In the initial phase, 18 patients were seen for a total of 53 visits; 78% were seen more than once, with a mean of three visits per patient. In the model phase, 46 patients were seen for a total of 163 visits; 74% were seen more than once, with a mean of 3.5 visits. Demographics were similar between the two groups. Content of the first PC visit in the initial and model phases was symptom management (61% and 57%), psychosocial support/relationship building (28% and 35%) and advance care planning/decision-making support (11% and 8%), respectively.
  
  
  CONCLUSIONS
  The initial phase demonstrated acceptability and feasibility of a model for embedded PC for patients and the oncology team. Establishment of specific eligibility criteria and screening to identify eligible patients in the model phase led to an increased uptake of PC for patients with advanced kidney cancer and melanoma in a cancer clinic.
authors.affiliation: Boston College, Wm. F.Connell School of Nursing, Chestnut Hill, Massachusetts, USA.|Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: DeSanto-Madeya
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: David
authors.initials: D
authors.lastname: McDermott
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Zerillo
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Weinstein
authors.affiliation: Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.|Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Buss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D019033:Delivery of Health Care, Integrated; D005260:Female; D006284:Health Plan Implementation; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008297:Male; D008404:Massachusetts; D008545:Melanoma / Q000628:therapy*; D008875:Middle Aged; D017146:Models, Organizational; D010166:Palliative Care / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration*; D011446:Prospective Studies; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000628:therapy*
keywords: embedded palliative care; model