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Background: Postgraduate fellowship training for nurse practitioners (NP) in palliative care can ameliorate workforce shortages; however, currently there are few NP fellowships and little evidence about outcomes, such as retention in hospice and palliative nursing, job satisfaction, or professional contributions. Objective: To describe the impact of palliative care fellowship training on the careers of NP alumni. Methods: A survey was electronically distributed to all NP alumni of an interprofessional palliative care fellowship since adult and pediatric nursing cohorts were added (2009–2022). Results: Most respondents still worked in hospice and/or palliative care; a majority of them engaged in professional activities beyond clinical work and reported high career satisfaction. Alumni endorsed multiple benefits of postgraduate fellowship except for post-fellowship compensation. Conclusions: NP palliative care fellowship alumni reported multiple career benefits including job satisfaction, professional accomplishment, and ongoing employment at their training institutions. [ABSTRACT FROM AUTHOR]

Outcomes 1. Discuss a novel model for providing integrated supportive oncology services in community settings 2. Demonstrate benefits of providing integrated supportive oncology services using patient case examples 3. Describe process and outcome metrics associated with implementing community-based psychosocial and palliative care services There is an unmet need for palliative care and psychosocial oncology in community settings and a limited workforce to provide these services. When faced with a similar challenge, the field of psychiatry developed a model called collaborative care to increase access to psychiatry in primary care and other settings. Collaborative care uses a mix of onsite behavioral health workers and offsite psychiatrists to provide evidence-based behavioral healthcare in community settings. There is an extensive literature demonstrating improved outcomes associated with collaborative care. At Dana-Farber, we have well-established palliative care and psychosocial services, but, historically, they were not easily available to patients in the community satellites. To bridge this gap, we developed an integrated model of psychosocial oncology and palliative care services called the Supportive Oncology Collaborative (SOC). Based on the collaborative care model, this program integrates onsite and virtual resources to create a cohesive team composed of palliative care clinicians, a psychiatrist, and social workers. We do not offer discrete palliative care, social work, or psychiatric services in the SOC but rather provide a comprehensive team approach for each clinical concern. This model is currently implemented in the Dana-Farber satellite location in Merrimack Valley, which serves a diverse general oncology adult population. There are plans to expand to 4 additional locations over the next 2 years. In this session, we will present information about collaborative care and how it was adapted into the SOC. We will provide case studies of treatment by the SOC to demonstrate the team-based approach and how it differs from standard clinical care. We will share information about the structure and function of the SOC and lessons learned from implementation, and finally we will share process and outcome metrics associated with the intervention. [ABSTRACT FROM AUTHOR]

Outcomes: 1. Describe a novel model for providing integrated supportive oncology services in community settings 2. List process and outcome metrics associated with implementing community-based psychosocial and palliative care services An unmet need for palliative care and psychosocial oncology in community settings and a limited workforce to provide these services necessitates innovation. When faced with similar challenges, the field of psychiatry developed the Collaborative Care model. Collaborative Care uses a mix of onsite behavioral health workers and offsite psychiatrists, as well as a measurement-based approach, to provide evidence-based behavioral health care in community settings. At Dana-Farber Cancer Institute, we aim to increase access to palliative care and psychosocial services in our diverse community satellites by enhancing collaborative care. We developed the Supportive Oncology Collaborative (SOC), a clinical model that integrates onsite and virtual resources to create a cohesive team of palliative care clinicians, a psychiatrist, and social workers. We do not offer discreet palliative care, social work, or psychiatric services in the SOC, but rather provide a comprehensive team approach for each clinical concern. This model is currently implemented in two Dana-Farber Cancer Institute satellite locations, with plans to expand to three additional locations over the next 2 years. In this session, we will present information about Collaborative Care, how it was adapted into the SOC, and how this differs from standard care delivery models. We will identify 10 common reasons for referral (eg, pain, goals of care, behavioral health, coping with illness) and the interdisciplinary clinical pathways we have developed for each. We will share process metrics such as clinical volume, patient risk stratification, and proportion of high-risk patients presented for clinical discussion at interdisciplinary team meeting. We will share an evaluation plan based on patient goals and linked to referral indications. Finally, we will share case studies to demonstrate how care is provided in this model in alignment with the clinical pathways. [ABSTRACT FROM AUTHOR]