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Background: Tele-palliative care is an effective method of providing care for patients who wish to receive their care locally. In an effort to provide care to veterans that live remotely the Palliative Care program at the Pittsburgh VAMC created a Palliative Care Telemedicine clinic. The clinic provides a patient centered approach by working with primary care and subspecialists to manage symptoms, establish patient’s expectations with treatment and to determine what the patient is willing to endure to reach his/her goals. Patient focused care provides better quality of care and may result in a decrease in unwanted and inappropriate admissions, readmissions, tests, procedures and transfers to a higher level of care that may not align with the patient’s goals of care.

Methods: In 2018 the Palliative Care program partnered with Oncology to provide comprehensive patient care by CVT. Patients who requested that their chemotherapy/ immunotherapy be done at the local VA were seen by Oncology in Pittsburgh with subsequent visits and treatment done in the infusion clinic at the local VA. Patients were seen by Oncology by CVT prior to each treatment, Patients with stage IV disease or who had extensive symptom burden were referred for telepalliative care and were seen on the same day that they were seen by their Oncologist.

Results: Since 2018, 51 patients with the diagnosis of cancer were referred for both Oncology and Palliative Care CVT. There were a total of 211 clinic visits. Patents were primarily referred for symptom management and goals of care. Since January 2018, 22 patients are alive, 24 patients have died and 5 patients are currently receiving hospice care. 21 patients died at home or in a CLC—1 died in the hospital and 2 sites of death are unknown.

Conclusion: Preliminary data suggests that tele-palliative care can provide effective symptom management and may reduce deaths in an acute care setting. The palliative care program plans to expand tele-palliative care by offering this service to other facilities in the VISN as well as partnering with home hospice agencies to provide VVC for patients that are on hospice.

Background: Tele-palliative care is an effective method of providing care for patients who wish to receive their care locally. In an effort to provide care to veterans that live remotely the Palliative Care program at the Pittsburgh VAMC created a Palliative Care Telemedicine clinic. The clinic provides a patient centered approach by working with primary care and subspecialists to manage symptoms, establish patient’s expectations with treatment and to determine what the patient is willing to endure to reach his/her goals. Patient focused care provides better quality of care and may result in a decrease in unwanted and inappropriate admissions, readmissions, tests, procedures and transfers to a higher level of care that may not align with the patient’s goals of care.

Methods: In 2018 the Palliative Care program partnered with Oncology to provide comprehensive patient care by CVT. Patients who requested that their chemotherapy/ immunotherapy be done at the local VA were seen by Oncology in Pittsburgh with subsequent visits and treatment done in the infusion clinic at the local VA. Patients were seen by Oncology by CVT prior to each treatment, Patients with stage IV disease or who had extensive symptom burden were referred for telepalliative care and were seen on the same day that they were seen by their Oncologist.

Results: Since 2018, 51 patients with the diagnosis of cancer were referred for both Oncology and Palliative Care CVT. There were a total of 211 clinic visits. Patents were primarily referred for symptom management and goals of care. Since January 2018, 22 patients are alive, 24 patients have died and 5 patients are currently receiving hospice care. 21 patients died at home or in a CLC—1 died in the hospital and 2 sites of death are unknown.

Conclusion: Preliminary data suggests that tele-palliative care can provide effective symptom management and may reduce deaths in an acute care setting. The palliative care program plans to expand tele-palliative care by offering this service to other facilities in the VISN as well as partnering with home hospice agencies to provide VVC for patients that are on hospice.

Background: Tele-palliative care is an effective method of providing care for patients who wish to receive their care locally. In an effort to provide care to veterans that live remotely the Palliative Care program at the Pittsburgh VAMC created a Palliative Care Telemedicine clinic. The clinic provides a patient centered approach by working with primary care and subspecialists to manage symptoms, establish patient’s expectations with treatment and to determine what the patient is willing to endure to reach his/her goals. Patient focused care provides better quality of care and may result in a decrease in unwanted and inappropriate admissions, readmissions, tests, procedures and transfers to a higher level of care that may not align with the patient’s goals of care.

Methods: In 2018 the Palliative Care program partnered with Oncology to provide comprehensive patient care by CVT. Patients who requested that their chemotherapy/ immunotherapy be done at the local VA were seen by Oncology in Pittsburgh with subsequent visits and treatment done in the infusion clinic at the local VA. Patients were seen by Oncology by CVT prior to each treatment, Patients with stage IV disease or who had extensive symptom burden were referred for telepalliative care and were seen on the same day that they were seen by their Oncologist.

Results: Since 2018, 51 patients with the diagnosis of cancer were referred for both Oncology and Palliative Care CVT. There were a total of 211 clinic visits. Patents were primarily referred for symptom management and goals of care. Since January 2018, 22 patients are alive, 24 patients have died and 5 patients are currently receiving hospice care. 21 patients died at home or in a CLC—1 died in the hospital and 2 sites of death are unknown.

Conclusion: Preliminary data suggests that tele-palliative care can provide effective symptom management and may reduce deaths in an acute care setting. The palliative care program plans to expand tele-palliative care by offering this service to other facilities in the VISN as well as partnering with home hospice agencies to provide VVC for patients that are on hospice.

Background: Understanding a patient’s expectations with treatment for their cancer is an important first step in caring for patients with cancer. Establishing goals of care allows providers to understand what their patients are willing to endure especially if they have a limited life expectancy. It provides a plan of care that is agreed upon by both the patient and provider. However, talking to patients about goals of care requires a skill set that many providers have not fully developed.

The use of simulated patients (SPs) has been shown to be an effective method to teach communication skills. However, many people feel intimidated when they are asked to work with SPs, especially if their conversations are viewed and critiqued by others. At the Pittsburgh VA we have developed a method that uses SPs to teach communication skills in a comfortable non-threatening environment for the learner. We tested this method with our Oncology providers.

Methods: Oncologists, nurses and social workers attended a meeting where they were asked to view a scenario where a patient and his family( SPs) were informed that the patient had progression of his cancer. In the first scenario the information was presented to SPs focusing on the cancer and treatment options. In the second scenario the same information was presented by an oncologist trained in palliative care focusing on the patient’s understanding of his disease and his goals of care. SPs were asked to contrast and comment on the different styles. The audience was then asked to provide comments and feedback.

Results: Twenty-two participants provided feedback. Twenty one of the participants agreed or strongly agreed that the simulation improved their knowledge and skill set and was done in a safe and comfortable learning environment.

Conclusions: Using SPs and allowing providers to contrast different styles of communicating the same set of information can be an effective and non-threatening teaching method of teaching communication skills. Longitudinal review of patient records will further help to determine the effectiveness of this method of training.

Background: Understanding a patient’s expectations with treatment for their cancer is an important first step in caring for patients with cancer. Establishing goals of care allows providers to understand what their patients are willing to endure especially if they have a limited life expectancy. It provides a plan of care that is agreed upon by both the patient and provider. However, talking to patients about goals of care requires a skill set that many providers have not fully developed.

The use of simulated patients (SPs) has been shown to be an effective method to teach communication skills. However, many people feel intimidated when they are asked to work with SPs, especially if their conversations are viewed and critiqued by others. At the Pittsburgh VA we have developed a method that uses SPs to teach communication skills in a comfortable non-threatening environment for the learner. We tested this method with our Oncology providers.

Methods: Oncologists, nurses and social workers attended a meeting where they were asked to view a scenario where a patient and his family( SPs) were informed that the patient had progression of his cancer. In the first scenario the information was presented to SPs focusing on the cancer and treatment options. In the second scenario the same information was presented by an oncologist trained in palliative care focusing on the patient’s understanding of his disease and his goals of care. SPs were asked to contrast and comment on the different styles. The audience was then asked to provide comments and feedback.

Results: Twenty-two participants provided feedback. Twenty one of the participants agreed or strongly agreed that the simulation improved their knowledge and skill set and was done in a safe and comfortable learning environment.

Conclusions: Using SPs and allowing providers to contrast different styles of communicating the same set of information can be an effective and non-threatening teaching method of teaching communication skills. Longitudinal review of patient records will further help to determine the effectiveness of this method of training.

Background: Understanding a patient’s expectations with treatment for their cancer is an important first step in caring for patients with cancer. Establishing goals of care allows providers to understand what their patients are willing to endure especially if they have a limited life expectancy. It provides a plan of care that is agreed upon by both the patient and provider. However, talking to patients about goals of care requires a skill set that many providers have not fully developed.

The use of simulated patients (SPs) has been shown to be an effective method to teach communication skills. However, many people feel intimidated when they are asked to work with SPs, especially if their conversations are viewed and critiqued by others. At the Pittsburgh VA we have developed a method that uses SPs to teach communication skills in a comfortable non-threatening environment for the learner. We tested this method with our Oncology providers.

Methods: Oncologists, nurses and social workers attended a meeting where they were asked to view a scenario where a patient and his family( SPs) were informed that the patient had progression of his cancer. In the first scenario the information was presented to SPs focusing on the cancer and treatment options. In the second scenario the same information was presented by an oncologist trained in palliative care focusing on the patient’s understanding of his disease and his goals of care. SPs were asked to contrast and comment on the different styles. The audience was then asked to provide comments and feedback.

Results: Twenty-two participants provided feedback. Twenty one of the participants agreed or strongly agreed that the simulation improved their knowledge and skill set and was done in a safe and comfortable learning environment.

Conclusions: Using SPs and allowing providers to contrast different styles of communicating the same set of information can be an effective and non-threatening teaching method of teaching communication skills. Longitudinal review of patient records will further help to determine the effectiveness of this method of training.