MO1-13-4Effect of Multi-professional Cooperation on Location for End-of-life care in Patients with Hematologic Malignancies

Abstract Background Previous research demonstrated that patients with hematologic malignancies are more likely to die in hospital than those with other cancers. In this study, we assessed the location for end-of-life in patients with hematologic malignancies before and after sharing their information and discussing end-of-life issues in a multi-professional meeting. Methods We conducted a retrospective cohort study in Komaki City Hospital. We reviewed the medical records of all adult patients who were discharged from the Department of Hematology between December 2016 and November 2018, and died of hematologic malignancies. After December 2017, primary doctors and nurses shared information about patients who stayed more than 14 days at the hematology ward every week. In selected cases, we discussed the patient’s end-of-life issues in a multi-professional meeting with the palliative care team based on the preferences of the patient and his or her family. In this study, we assessed the location where the patients stayed for the last 30 days of life, place of death and duration of hospital stay before death in acute wards before and after sharing information on patients in primary teams. Results A total of 73 patients who were discharged from the Department of Hematology and died from hematologic malignancies were identified: 36 before and 37 after December, 2017. Average length of stay at home in the last 30 days of life was significantly prolonged from 6.5 days before, to 12.2 days after, this period (P = 0.021). Deaths at home increased from one (3%) before to four (11%) after. Average length of stay in the hospital before death was significantly shortened from 38.5 days before to 14.5 days after in patients who died in the acute wards (P = 0.017). Conclusion These results suggest that multi-professional cooperation affects the location for end-of-life care in patients with hematologic malignancies.