Retrospective Chart Review of Metastatic Solid Tumor Discharges to Subacute Rehab

Introduction: Regaining strength through rehabilitation as a mechanism to return cancer patients to therapy is poorly understood and therefore realistic advice cannot be given to patients when cancer-directed therapy must be stopped. This research examines what cancer patients are able to accomplish following referral to subacute rehabilitation (SAR). It was hypothesized that the majority of patients would not return to cancer-directed therapy following SAR and that a high functional status at discharge would be the best predictor of this return. Methods: A retrospective chart review was completed for 112 metastatic solid tumor patients discharged to SAR (2018-2020). The primary outcome was patient return to anti-cancer therapy and a physical therapist assigned functional status score (AMPAC) was the main proposed predictor. The association between the AMPAC score and return to cancer-directed therapy was evaluated using logistic regression. Results: Only 31 of the 112 patients (28%) returned to cancer-directed therapy within 60 days of discharge to SAR. Functional status score was positively associated with return to cancer-directed therapy. The average survival for patients was 36 days from original discharge and 40% of patients were readmitted to the hospital within 30 days. Conclusion: The majority of patients who were discharged to SAR were unable to return to cancer-directed therapy. While SAR may have other benefits, it is important to be realistic with cancer patients when cancer-directed therapy must be stopped. Functional status before discharge to SAR is a useful tool for guiding patients about their likelihood of return to therapy

Caregiver Evaluation of a Palliative Care Consultation Team Using the Jefferson Teamwork Observation Guide (JTOG) by Caregivers of Severely Ill Patients

Background: Palliative care teams strive to improve the quality of life of patients and their families who are faced with life threatening illnesses by addressing the physical, psychosocial and spiritual aspects of their care (World HealthOrganization, 2017). The palliative care team is an interprofessional team made up of physicians, nurses, social workers and chaplains and often partners with many other disciplines. Palliative care has been shown to increase quality of life in patients with cancer and help improve communication amongst patients, their families and their care teams (Temel, 2010; Seow, 2008). Additionally, many studies have sought to prove the effectiveness of palliative care using validated tools such as the FAMCARE survey with mixed results (Parker, 2013). The goal of this project was to use a different validated tool, the JTOG, to analyze the effectiveness of our interprofessional team. Because palliative care is not a medical specialty whose effectiveness can be measured by procedural outcomes, teams often seek using satisfaction scores as a means of measuring how well they are doing. The JTOG replaced our prior patient satisfaction survey. The results are described below