Date of Award

Spring 2023

Document Type

DNP Project

Degree Name

Doctor of Nursing Practice (DNP)



Committee Chairperson

Marguerite Ambrose, Ph.D., RN, ACNS-BC, CNE

Committee Member

Megan Mraz, RN, Ph.D.



Patients diagnosed with an advanced disease or serious illness often experience a variety of distressing symptoms that can negatively impact their functional status and quality of life. Outpatient palliative care is a medical specialty that often requires a referral from a primary care or specialty care provider who has identified a need for specialized pain and symptom management, psychosocial or caregiver distress, end-of-life care management, or goals of care discussions. Despite notable effectiveness in the provision of palliative care for patients with advanced disease and serious illness, barriers exist that prevent patients from accepting palliative care referrals even after a need has been identified by their referring provider. This DNP project aimed to increase the rate of palliative care referral acceptance rates in adult patients referred to the outpatient palliative care team within Sansum Clinic, by incorporating an APRN-led workflow change into the initial outreach process for patients referred to the team. Referral and demographic data were analyzed for this DNP project. Considerations for future educational, clinical and research opportunities are discussed.