TY - JOUR
T1 - Adherence to Measuring What Matters Items When Caring for Patients With Hematologic Malignancies Versus Solid Tumors
AU - LeBlanc, Thomas W.
AU - Ritchie, Christine S.
AU - Friedman, Fred
AU - Bull, Janet
AU - Kutner, Jean S.
AU - Johnson, Kimberly S.
AU - Kamal, Arif H.
AU - Aslakson, Rebecca A.
AU - Ast, Katherine
AU - Elk, Ronit
AU - Garner, Kimberly K.
AU - Gramling, Robert
AU - Grudzen, Corita
AU - Lamba, Sangeeta
AU - Rhodes, Ramona L.
AU - Roeland, Eric
AU - Schulman-Green, Dena
AU - Unroe, Kathleen T.
N1 - Funding Information:
This study was funded by an Agency for Healthcare Research and Quality (AHRQ) R18 grant ( 1R18-HS022763-02 ; principal investigator [PI]: Johnson). Dr. LeBlanc reports research funding related to this work from the Cambia Health Foundation . Dr. Kamal reports research funding related to this work from the AHRQ (grants K08 HS023681 , PI: Kamal; 1R18-HS022763-02 , PI: Johnson), and Cambia Health Foundation . Dr. Bull reports research funding related to this work from the AHRQ (grant 1R18-HS022763-02 , PI: Johnson), and the National Institute of Nursing Research (NINR, 5U24NR014637 , PI: Kutner). Dr. Kutner reports research funding related to this work from the AHRQ ( 1R18-HS022763-02 , PI: Taylor) and the NINR ( 5U24NR014637 , PI: Kutner). Dr. Ritchie reports research funding related to this work from the AHRQ ( 1R18-HS022763-02 , PI: Johnson), the NINR ( 5U24NR014637 , PI: Kutner), the Retirement Research Foundation , the California HealthCare Foundation , and the Commonwealth Fund (PI: Ritchie). The authors have no relevant conflicts to disclose.
Publisher Copyright:
© 2016 American Academy of Hospice and Palliative Medicine
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Context Measuring What Matters (MWM) prioritizes quality measures in palliative care practice. Hematologic malignancy patients are less likely to access palliative care, yet little is known about their unique needs. Differences in MWM adherence may highlight opportunities to improve palliative care in hematology. Objectives To assess adherence to MWM measures by palliative care clinicians caring for patients with hematologic malignancies, compared to those with solid tumors. Methods We used the Quality Data Collection Tool to assess completion of MWM measures across nine sites. Results We included data from 678 patients' first visits and various care settings; 64 (9.4%) had a hematologic malignancy, whereas 614 (90.6%) had a solid tumor. Hematology patients were more likely to be seen in a hospital (52 or 81.3% vs. 420 or 68%), whereas solid tumor patients were more frequently seen at home or in clinics (160 or 26% vs. 7 or 10.9%). Of the nine MWM measures we assessed, high adherence (>90%) was seen regardless of tumor type in measures #3 (Pain Treatment), #7 (Spiritual Concerns), #8 (Treatment Preferences), and #9 (Care Consistent With Preferences). Clinicians seeing hematology patients were significantly less likely to meet measures #2 (Screening for Physical Symptoms; 57.8% vs. 84.2%, P < 0.001), and #5 (Discussion of Emotional Needs; 56.3% vs. 70.0%, P = 0.03). Conclusion MWM adherence regarding symptom assessment and meeting emotional needs was lower for patients with hematologic malignancies compared to those with solid tumors. This finding suggests two key areas for quality improvement initiatives in palliative care for patients with hematologic malignancies.
AB - Context Measuring What Matters (MWM) prioritizes quality measures in palliative care practice. Hematologic malignancy patients are less likely to access palliative care, yet little is known about their unique needs. Differences in MWM adherence may highlight opportunities to improve palliative care in hematology. Objectives To assess adherence to MWM measures by palliative care clinicians caring for patients with hematologic malignancies, compared to those with solid tumors. Methods We used the Quality Data Collection Tool to assess completion of MWM measures across nine sites. Results We included data from 678 patients' first visits and various care settings; 64 (9.4%) had a hematologic malignancy, whereas 614 (90.6%) had a solid tumor. Hematology patients were more likely to be seen in a hospital (52 or 81.3% vs. 420 or 68%), whereas solid tumor patients were more frequently seen at home or in clinics (160 or 26% vs. 7 or 10.9%). Of the nine MWM measures we assessed, high adherence (>90%) was seen regardless of tumor type in measures #3 (Pain Treatment), #7 (Spiritual Concerns), #8 (Treatment Preferences), and #9 (Care Consistent With Preferences). Clinicians seeing hematology patients were significantly less likely to meet measures #2 (Screening for Physical Symptoms; 57.8% vs. 84.2%, P < 0.001), and #5 (Discussion of Emotional Needs; 56.3% vs. 70.0%, P = 0.03). Conclusion MWM adherence regarding symptom assessment and meeting emotional needs was lower for patients with hematologic malignancies compared to those with solid tumors. This finding suggests two key areas for quality improvement initiatives in palliative care for patients with hematologic malignancies.
KW - Hematology
KW - Measuring What Matters
KW - QDACT
KW - blood cancers
KW - collaboratives
KW - hematologic malignancies
KW - palliative care
KW - quality
KW - quality measures
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U2 - 10.1016/j.jpainsymman.2016.09.004
DO - 10.1016/j.jpainsymman.2016.09.004
M3 - Article
C2 - 27810570
AN - SCOPUS:85002941127
SN - 0885-3924
VL - 52
SP - 775
EP - 782
JO - Journal of Pain and Symptom Management
JF - Journal of Pain and Symptom Management
IS - 6
ER -