From Pilot to Practice: Scaling a Supportive Oncology Innovation Across a Cancer Center

Key Message: We will describe a supportive oncology clinical innovation implemented at an academic cancer center. We will present the steps we took, the tools we used and share how the collaborative work of an interprofessional team of palliative care clinicians, social workers, psychiatrists, and psychologists changed delivery of supportive care.

Abstract: The Supportive Oncology Collaborative (SOC) is a clinical innovation developed at the Dana-Farber Cancer institute (DFCI), designed to increase access to supportive oncology services and improve outcomes (1), Building on the evidence-based Collaborative Care Model — a population health approach to integrating behavioral health into primary care settings—the SOC integrates comprehensive supportive oncology services into an oncology setting (2). Beginning in a single clinical site in 2020, the SOC has grown to become the model that transforms how supportive care is delivered at seven of the DFCI campuses.

Session Format: We will describe the SOC and how it delivers integrated behavioral health and palliative care in a stepped care fashion across patient populations, disease types, and clinic settings, and will share the implementation model used for expansion. This presentation will also cover our implementation and quality improvement strategy using process and clinical outcomes as we scale across the institution. Additionally, we will share examples of ongoing innovation including communication through nurse navigators and the use of psychology to support clinicians and high-risk patients.

We will present tools including:
1. A clinical playbook guiding the interprofessional management of physical and psychological symptoms such as depression, anxiety, and pain.
2. A manual that defines core components, clinical competencies, and a large-scale training program for social workers who serve as primary clinicians in this model.
3. An analytical approach aligned with the success and sustainability of SOC, including a real time dashboard that tracks outcomes and provides guidance to the clinical teams.
4. The leadership and workstream structure supporting sustained implementation.

Takeaways: The SOC evolved from a pilot to the core clinical model for supportive oncology, significantly expanding patient access and improving care delivery. This transformational approach can be replicated and applied across health settings, particularly those looking to expand palliative care’s reach.

References: 1. Lally K, Macip-Rodriquez P, Wu C, McGuire H, Pirl W. The Supportive Oncology Collaborative: Expanding upon Collaborative Care to Increase Supportive Care Access in Underserved Populations. J Palliat Med. 2024 Jun;27(6):789-793. doi: 10.1089/jpm.2023.0617. Epub 2024 Apr 11. PMID: 38602266.
2. Ratzliff A, Unutzer J Katon W Stephens K. Integrated Care: Creating Effective Mental and Primary Care Teams. 1st ed. Wiley.