726: A Structured Care Coordination Tool for Solid Oncology Patients Admitted to the Medical Icu

Introduction: Advanced treatment options for solid oncology patients have resulted in improved prognosis and new complications from therapy. Such patients risk diagnostic error, inaccurate prognostication, and goal-discordant care in the absence of deliberate collaboration with ambulatory oncologists. We hypothesized that a standardized tool would improve care coordination and documentation for solid oncology patients admitted to the medical ICU (MICU). Methods: We conducted voice of the customer interviews with medical critical care clinicians and oncologists. Using stakeholder input to guide content, we developed and implemented a care coordination tool for solid oncology patients admitted to MICU, leveraging the advanced care planning (ACP) documentation tool in the electronic medical record. We measured ACP notes documented in solid oncology patients within 48 hours of MICU admission, comparing the six months before tool implementation (October 2024-March 2025) to the four months after (April-July 2025). Results: We developed a structured email communication to ambulatory oncologists from the MICU team notifying them of the patient’s admission and querying the following aspects of their cancer care: current therapy intent, future available therapies, prognosis, prior discussion of patient goals of care and treatment preferences, and recommendations for ongoing inpatient care coordination. The MICU team then captures the content in an ACP note. Four months after implementation, 81% (30/37) of solid oncology patients had ACP documentation within 48 hours of MICU admission compared to 44% (25/57) in the prior six months. The tool increased ACP documentation significantly (p = 0.0003). Conclusions: We implemented a care coordination tool for solid oncology patients admitted to the MICU and demonstrated high initial uptake. This tool facilitates standardized, early engagement of ambulatory oncologists, sharing of key oncology-specific information to ICU teams, and improved ACP documentation. Future work will examine the tool’s impact on ICU care processes and patient outcomes.