Automatic referral to standardize palliative care access : an international Delphi survey

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Hui , D , Mori , M , Meng , Y-C , Watanabe , S M , Caraceni , A , Strasser , F , Saarto , T , Cherny , N , Glare , P , Kaasa , S & Bruera , E 2018 , ' Automatic referral to standardize palliative care access : an international Delphi survey ' , Supportive Care in Cancer , vol. 26 , no. 1 , pp. 175-180 .

Title: Automatic referral to standardize palliative care access : an international Delphi survey
Author: Hui, David; Mori, Masanori; Meng, Yee-Choon; Watanabe, Sharon M.; Caraceni, Augusto; Strasser, Florian; Saarto, Tiina; Cherny, Nathan; Glare, Paul; Kaasa, Stein; Bruera, Eduardo
Contributor organization: Clinicum
Department of Oncology
University of Helsinki
HUS Comprehensive Cancer Center
Date: 2018-01
Language: eng
Number of pages: 6
Belongs to series: Supportive Care in Cancer
ISSN: 0941-4355
Abstract: Palliative care referral is primarily based on clinician judgment, contributing to highly variable access. Standardized criteria to trigger automatic referral have been proposed, but it remains unclear how best to apply them in practice. We conducted a Delphi study of international experts to identify a consensus for the use of standardized criteria to trigger automatic referral. Sixty international experts stated their level of agreement for 14 statements regarding the use of clinician-based referral and automatic referral over two Delphi rounds. A consensus was defined as an agreement of ae70% a priori. The response rate was 59/60 (98%) for the first round and 56/60 (93%) for the second round. Twenty-six (43%), 19 (32%), and 11 (18%) respondents were from North America, Asia/Australia, and Europe, respectively. The panel reached consensus that outpatient palliative care referral should be based on both automatic referral and clinician-based referral (agreement = 86%). Only 18% felt that referral should be clinician-based alone, and only 7% agreed that referral should be based on automatic referral only. There was consensus that automatic referral criteria may increase the number of referrals (agreement = 98%), facilitate earlier palliative care access, and help administrators to set benchmarks for quality improvement (agreement = 86%). Our panelists favored the combination of automatic referral to augment clinician-based referral. This integrated referral framework may inform policy and program development.
Subject: Critical pathways
Delphi technique
Palliative care
Referral and consultation
3122 Cancers
Peer reviewed: Yes
Usage restriction: openAccess
Self-archived version: publishedVersion

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