QOL-13. ESTABLISHMENT OF A REHABILITATION CLINICAL SPECIALIST IN ONCOLOGY SIGNIFICANTLY IMPROVED REHABILITATION ACCESS FOR PEDIATRIC NEUROONCOLOGY PATIENTS: A SINGLE INSTITUTION EXPERIENCE

Abstract

Pediatric survivors of central nervous system (CNS) tumors face decreased physical, cognitive, and social function, resulting in poorer quality of life. Impairments, including weakness, ataxia, visual-perception disturbance, lower cognition, aphasia, dysphagia, and dysarthria, may be addressed by rehabilitation; however, services can be challenging to provide in the environment of surgery, radiation, and chemotherapy. Children's Minnesota developed the rehabilitation clinical specialist in oncology (RCSO) role, which targeted improving rehabilitation through increasing interdisciplinary collaboration, defining a specialized rehabilitation team, providing outpatient (OP) services within the cancer clinic, improving OP scheduling, and designing inpatient (IP) clinical pathways and order sets. METHOD(S): We compared IP and OP physical therapy (PT), occupational therapy (OT), and speech language pathology (SLP) visits for all children with CNS tumors from diagnosis to 3 years post-diagnosis in a historical cohort (2001-2006) pre-RCSO and current cohort (2009-2014) post-RCSO. RESULT(S): Patient totals included 155 historical and 221 current patients. Rehabilitation referral percentages grew in IP and OP settings (IP 28.04% and OP 154.70%). Average rehabilitation visits per patient grew in IP by 26.33%, and in OP by 131.82%. The largest areas of growth were OP OT (3.21 to 12.61 visits) and OP PT (7.14 to 21.41 visits). The growth in OP rehabilitation in the neurooncology population surpassed the overall growth of rehab in all populations at Children's. CONCLUSION(S): Implementation of the RSCO role and access systems improved rehabilitation services for neurooncology patients. Further investigation is needed regarding the impact of improved rehabilitation access and service on function and quality of life.