The following is a summary of “National Survey Using CFIR to Assess Early Outpatient Specialty Palliative Care Implementation,” published in the MARCH 2023 issue of Pain Management by Rosenblum, et al.

ASCO recommended that outpatient specialty palliative care (OSPC) be given within eight weeks of an advanced cancer diagnosis. To cope with the increasing demand, there has been a growth in the availability of OSPC services at the National Cancer Institute (NCI)-designated cancer centers. 

However, many patients are referred to OSPC services later in the disease course. For a study, researchers sought to use the Consolidated Framework for Implementation Research (CFIR) to evaluate the facilitators and barriers to early OSPC implementation and associated clinic characteristics. 

They chose relevant CFIR constructs and distributed a survey to the OSPC clinic leader at each NCI-designated cancer center, instructing them to rate their degree of agreement on a five-point Likert scale. Descriptive statistics were used to summarize the survey results and explore differences in barriers based on OSPC clinic size and maturity.

Out of 60 eligible sites, 40 (67%) completed the survey. The most commonly agreed-upon barriers to early OSPC were an inadequate number of OSPC providers (73%), lack of metric performance goals (65%), insufficient space to deliver early OSPC (58%), logistical challenges created by early OSPC (55%), and the absence of formal interdisciplinary communication systems (53%). The most frequently reported barriers varied depending on clinic size and maturity.

In conclusion, most barriers to early OSPC implementation were modifiable and were related to the “Inner Setting” domain of the CFIR. It highlighted leadership’s need for careful strategic planning when implementing early OSPC.

Reference: jpsmjournal.com/article/S0885-3924(22)01000-4/fulltext