• Sydney M Dy, Donald J List, Cynthia Barbe, and Louise Knight.
• The Harry J. Duffey Family Pain and Palliative Care Program, Johns Hopkins Sidney Kimmel Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland, USA. Electronic address: sdy@jhsph.edu.
• J Pain Symptom Manage. 2014 Jul 1;48(1):127-31.

BackgroundSubacute rehabilitation may not be appropriate for many patients with advanced cancer. We evaluated outcomes of cancer center inpatients transferred to subacute rehabilitation, implemented a multidisciplinary intervention to improve appropriateness of referrals, and evaluated its potential impact.MeasuresPercentage of patients who returned for further anticancer treatment after subacute rehabilitation (preintervention) and percentage of patients who were referred and transferred to subacute rehabilitation (pre and post).InterventionStakeholder engagement; feedback about outcomes to faculty and staff; increased communication between therapy, social work, nursing, and physicians about therapy referrals; and goals of care at daily prerounds meeting.OutcomesPotential reduction in subacute rehabilitation referrals and transfers. Intensive intervention was difficult to maintain, but team is continuing efforts at improved communication.Conclusions/Lessons LearnedIntervention may have improved outcomes short-term but was complicated and difficult to maintain. Addressing appropriateness of subacute rehabilitation referrals can occur within a multidisciplinary approach to improving communication about goals of care for patients with advanced disease.Copyright © 2014 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

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