Clement, Olivia2025-05-272025-05-272025-05https://archive.hshsl.umaryland.edu/handle/10713/23630Problem & Purpose: Ambulatory oncology patients often experience distress related to their symptoms, and evidence suggests that palliative care (PC) can reduce distress and increase patient quality of life. At the project site, a large ambulatory cancer center, patients were not consistently being referred to PC despite screening for high distress on the National Comprehensive Cancer Network Distress Thermometer (DT). The purpose of this quality improvement project was to increase palliative care referrals among ambulatory oncology patients at the cancer center by implementing an automated PC referral for patients who score ≥6/10 on the DT and to improve staff knowledge on the importance of PC. Methods: An interdisciplinary team of stakeholders was created. This team developed an automated referral process for PC consult into the EHR. Any patient who scored ≥6 on the DT would trigger a referral to PC. The team also provided education to oncology physicians and nurse coordinators on the new referral process. Results: After implementing the project, 96% (n=44) of patients with a distress level of ≥6 received a PC referral. For 13 out of the 15 weeks of data collection, 100% of patients with a distress level of ≥6 received a PC referral. Additionally, 50% (n=22) of patients who received a PC referral had an appointment scheduled within one month of the referral. Conclusions: Although the project goals were not met (since not all patients with a distress level of ≥6 received a PC referral), the project still had an overall positive impact. The results align with existing literature, showing that automated referrals can increase PC referrals and that the DT is an effective tool for identifying oncology patients who could benefit from PC. This project demonstrates that using the DT to identify patients in distress, combined with automated PC referrals, can lead to more timely and appropriate referrals without adding to the workload of staff or nurses.en-USMedical OncologyAmbulatory CareQuality ImprovementHealth Information SystemsPsychological DistressSeverity of Illness IndexDNP ProjectWilson, Tracey L.