Background From the perspective of oncology patients, the financial burden of paying for cancer care is as concerning as their own potential mortality (ASCO, 2018). Even richly resourced large academic cancer centers are not immune: a review of data at large comprehensive cancer center in 2018 revealed 25% of patients showed markers of financial toxicity (Aviki et al, 2021).

Objectives As healthcare professionals we agree that change is needed to improve health outcomes for our patients, but great ideas, great research and great possibilities become trapped in the quagmire of our own systems. The question to answer in this session is not what the barriers to implementing change are, but to consider how we contribute to their very existence, and how we change these behaviors.

Methods Through multi-professional brainstorming, it was decided to develop and implement an order-set that would allow any member of the care team to place a referral for a patient to receive financial assistance. Through a collective effort, this order-set was designed, implemented, and promoted to all disciplines.

Results From March 2021 to February 2022 over $1 million dollars of copay assistance was distributed based on clinician identification of financial toxicity and subsequent use of the orderset for referral to Patient Financial Services (figure 1).

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Abstract 19 Figure 1

Clinical referrals to patient financial services

Conclusions Employing a merged and forward focused group established the connection needed to create accountability across disciplines and to ensure the sustainability of the intervention. Core members of the task force shared responsibility for both the communication to executive leadership and interventions monitoring. Intervention education was approached broadly, with cross over from one professional sphere to another, providing valuable continuity.