Palliative care from cancer diagnosis for all: Memorial Sloan Kettering’s “One-Two-Three” program.

2017 
111Background: Early, universal palliative care is an unmet need for cancer patients. Our new program aims to provide palliative care, by primary oncology teams with support from palliative care specialists, from diagnosis as an institutional standard. Methods: One-Two-Three is a structured program of assessment and response addressing palliative care needs regardless of cancer stage or prognosis starting with the first 3 visits after diagnosis. Assessments include patient physical/emotional/spiritual symptoms (10 symptoms, self-reported 0-10), communication needs (information preferences, illness understanding), and proactive care planning through exploration of core values. As first responders, oncology nurses are guided by “ready responses” in an empathic framework and coaching or direct patient consultation by palliative care specialists. Feasibility, acceptability, and impact on patient, caregiver, and utilization outcomes are evaluated quantitatively and qualitatively. Results: Assessments were pilo...
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