Abstract Details

Title Implementing Team-Based Outpatient Palliative Care in Parkinson’s Foundation Centers of Excellence (COE): Study Design

Topic Pain

Presentation(s) P1 - Poster Session 1 (8:00 AM-9:00 AM)

Poster/Presentation
Number 12-006

Objective To describe the study design and early lessons of an implementation project aiming to make integrated palliative care (PC) a new standard of care across the 33 US Parkinson's Foundation Centers of Excellence (COEs).

Background Despite mounting evidence on the benefits of integrated PC approaches for persons with neurologic illness and their families, there are few models of how to implement and disseminate this model of care. This project seeks to implement PC across a large and diverse network of movement disorders centers serving approximately 140,000 patients annually. Our core intervention is based on a successful model of team-based PC that was developed in three US Parkinson’s Foundation COEs and validated in a multisite, randomized controlled trial.

Design/Methods We operationalized PC around five measurable and actionable pillars (non-motor symptom management, advance care planning, caregiver support, emotional/spiritual support, and timely referral to hospice) to create our core intervention. We followed the Exploration Preparation Implementation Sustainment (EPIS) framework to guide the phases of implementation. Mixed methods and the Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework will be used to track the impact and success of implementation efforts.

Results While healthcare providers were enthusiastic about this project, initial concerns were raised regarding time, need for PC education, care coordination, institutional support and business models. Implementation strategies to be deployed include educational modules, support for local PC champions, quality improvement coaching, creation of PC communities within and across COE, and development of shared central resources through the Parkinson's Foundation.

Conclusions There is a need for implementation and dissemination research in neurology. Established implementation science frameworks can be applied to spread complex clinical innovations in neurology practice. The methods and design of this project are relevant to health service researchers and quality improvement faculty interested in increasing uptake of palliative care or other evidence-based interventions.

Authors/Disclosures
Megan Dini, MA (The Parkinson's Foundation) PRESENTER	Mrs. Dini has received personal compensation for serving as an employee of Parkinson's Foundation .
	No disclosure on file
	No disclosure on file
	No disclosure on file
Peggy Auinger (University of Rochester)	Ms. Auinger has nothing to disclose.
Nicole A. Lessard, RN (Parkinson’s Foundation)	Ms. Yarab has nothing to disclose.
Benzi Kluger, MD, FAAN (University of Rochester)	Dr. Kluger has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for International Neuropalliative Care Society. Dr. Kluger has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Annals of Palliative Medicine. The institution of Dr. Kluger has received research support from NIH. The institution of Dr. Kluger has received research support from PCORI.

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