| Sumario: | Background & Significance: Despite the high morbidity and symptom burden, patients undergoing HSCT and CAR-T therapy often lack routine palliative care. At our institution, an evidence-based PPC intervention focused on discussing patients' health-related values (HRV) was successfully implemented for solid tumor and hematologic malignancy patients. While this approach has become the standard of care for patients undergoing cell therapy, there is limited information on RN/APP perceptions of participating in this care. Purpose: We elicited feedback on RN/APP experiences reading or completing a HRV discussion, perceived barriers to completing one, impact on caring for patients, and benefits (if any) to the patient and family. Methods: The HRV assessment is an easy tool for non-specialist palliative care providers to understand what is most important to patients and engage in advance care planning. We provided education on this tool to the service, including helpful tips for initiating these conversations. Staff were surveyed on their experiences accessing HRV info, engaging in a HRV discussion, and their opinions on how it impacted their understanding and care of patients. Findings and Interpretations: 78 values discussions were performed over three months. Many RNs/APPs (n=32) reported that having a HRV discussion led to increased understanding of what is most important to the patient and positively impacted treatment planning. Many providers (n=29) felt implementing these discussions strengthens the relationship between provider and patient and increased patients' comfort. It established attainable goals that the multidisciplinary team could work together to facilitate. The most common barrier was time constraints (n=13). Others included language barriers and apprehension that patients would respond negatively to the conversation. Discussion: Given the high demand for specialty palliative care and a limited workforce to meet these needs, it is essential that oncology RNs/APPs provide PPC. Through education and empowerment, providers gain confidence to incorporate this into routine care. Both patients and providers benefited from the implementation of PPC. It also shifted the provider's perspective and increased job satisfaction. Lack of knowledge, support and time remain ongoing barriers to having these conversations. At our institution we created a separate visit to have HRV discussions. Through further dissemination, we hope to expand to other services.
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