Gentes, Rachel C.

Purpose There is emerging evidence that music therapy (MT) is an effective tool within palliative care to manage patients’ complex needs. This performance improvement project aimed to assess palliative care staff members’ attitudes toward the current utilization of MT within the institution’s hospital-based interdisciplinary practices. Methods Eighty-four staff members practicing within hospital-based palliative care teams were invited to complete a voluntary anonymous mixed methods survey about their impressions of current MT integration. Survey questions inquired about reasons for MT referral, most common pertinent symptoms, perceived benefit to patients, future suggestions for growth, unexpected experiences, and perceived personal benefit to staff. Major Findings Fifty-one staff members (61%) responded. Top reasons for MT referral were psychosocial support, pain and symptom management, and coping. The most common symptom-focused indications were anxiety, mood, and existential distress. A variety of factors influenced decisions to refer for MT. Most felt that at least half of their patients could benefit from MT, and nearly all rated MT as “extremely” or “very” effective for improving patients’ quality of life. Suggestions for potential growth for MT in palliative care in the future centered on themes of greater availability, increased variety and collaboration, research opportunities, and staff members’ desire to receive more exposure to MT. Conclusions In this single-institution performance improvement project, staff attitudes were highly favorable toward MT for palliative care patients. MT is utilized for a variety of reasons, can be highly effective for improving patients’ quality of life, and may also be of direct benefit to staff.

Abstract To date, nearly 40 U.S. states have passed the Caregiver Advise Record and Enable (CARE) Act to support family caregivers during transitions from hospital to home. These laws require hospitals to: 1) record designated family caregivers’ name in a patient medical records during a hospital stay; 2) inform the caregiver when the patient will be discharged; 3) provide education and instructions on care tasks needed for post-hospital discharge. Transitions from hospital to home are often fraught with adverse event risk and poor continuity of care, especially for rural patients with progressive life-limiting conditions. The CARE ACT has potential to address healthcare system factors that are sometimes attributable to poor transitions in care. Our presentation focuses on preliminary findings from an intervention that provides teaching, guidance, and counseling to caregivers caring for an individual receiving palliative care in the hospital and transitioning home to a rural setting. Findings suggest that the CARE ACT may be vital, but not fully sufficient, for successful transitions. Additional targets for caregiver interventions to improve transitions for this subset of very ill patients include: 1) attend to caregivers’ medical and non-medical needs which may impact their capacity to provide care; 2) advise clinical teams to communicate truthfully about prognosis and likely outcomes when creating post-hospital plans of care; 3) encourage caregivers to identify and engage services early in the transition; 4) urge caregivers to draw on multiple sources for social support. Findings can help optimize the CARE Act implementation, particularly in states with large rural populations.

Objectives: Recent evidence suggests that music therapy, a holistic method of care, potentially is beneficial for symptom management. This quality improvement project aimed to evaluate the effect of music therapy on symptom management and coping skills of patients receiving palliative care and to measure patient satisfaction with the therapy. A secondary aim was to evaluate staff perception of patient outcomes of music therapy services. Methods: Palliative care clinicians attended a 30-minute education session on music therapy before the project was initiated. Study participants were patients and their families who were cared for by the inpatient palliative care consulting service at Mayo Clinic (Rochester, Minnesota) from June 1 through December 31, 2016. Patients were eligible if they required ongoing management of pain and anxiety or needed adaptive coping strategies. Patients and families were asked to complete a survey after each music therapy session. Staff were asked to complete a survey after completion of the project. Results: Music therapy was provided to 57 patients and 53 family members. Patient surveys indicated a decrease in anxiety and pain. All patients reported that music therapy facilitated stress relief, relaxation, pain relief, spiritual support, emotional support, and a general feeling of wellness. All participants recommended music therapy services for others. Palliative care clinicians reported that music therapy added value as a holistic service. Conclusions: In this quality improvement project, music therapy positively affected multiple domains of well-being for patients receiving palliative care.