Congress Abstracts 2003

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DELEtCC: DISSEMINATING END-OF-LIFE EDUCATION TO CANCER CENTERS. Jo Hanson, RN, MSN, OCN^®, and Marcia Grant, RN, DNSc, FAAN, City of Hope National Medical Center, Duarte, CA.

Within the next 10 to 15 years, cancer will surpass cardiovascular disease as the number one cause of death in the United States. In 2001, 555,500 deaths or 1 in 4 was because of cancer. The 2001 Institute of Medicine (IOM) Report identified the need for education to cancer centers. The overall purpose of this National Cancer Institute (NCI)-funded interdisciplinary educational project is to improve end-of-life (EOL) care for patients with cancer.

The project framework has three components: practice changes via performance improvement (PI); adult education principles; and educational content based on the Precepts of Palliative Care.

The 2002 course attracted 100 participants representing 50 institutions (16 NCI designated, 26 community cancer centers, 8 others) from 29 states. Teams of two healthcare professionals (87 females and 13 males) including 66 nurses, 14 physicians, 9 social workers, and 11 others (psychologists, pharmacists, chaplains, and therapists) completed the three-day intensive EOL care course in Pasadena, CA. Teams developed pre- and postcourse institutional goals. Precourse chart audits, case analysis, and institutional assessment were completed. Six-, 12-, and 18-month goals will be reassessed and revised and chart audits, case analysis, and institutional assessment completed. Curriculum included nine cancer-focused modules: Gaps in EOL Care; Pain Management; Symptom Management; Ethical/Legal Issues; Grief, Loss, Bereavement; Communication; Last Phase of Life; Quality Care at the EOL. Issues of culture were woven throughout each module. Teaching methods included podium lecture, large group and small group breakout sessions, panel discussions, and videotapes with participant interaction.

Course evaluations were extremely positive: overall mean 4.53 on a 1–5 point scale. Participants cited excellence of the speakers, extensive teaching materials, relevance to current issues, and overall course organization and presentation as outstanding. “Best speakers I have had the privilege to hear in 35 years.” “Networking, tools/resources are incredible!” “Excellent topics and take-home information for people who are trying to develop palliative care programs.”

The 2002 DELEtCC course was an overwhelming success and represents the first step in improving EOL care in cancer centers. The 50 institutions can improve cancer care for hundreds of patients with cancer.