Shaw At Home: An Oncology Specific Home and Community-Based Palliative Care Program

This is the sixth blog post in a 6-part series recognizing the achievements of the 2025 ACCC Innovator Award winners before their in-depth sessions at the ACCC 42nd National Oncology Conference. Learn more about the innovations being recognized this year and those who pioneered them by joining ACCC in Denver, Colorado, from October 15-17, 2025.

The estimated 60 million individuals living in rural communities in the US face a variety of social drivers of health, resource limitations, and health disparities that limit their access to high-quality health care. After witnessing patients in their community struggle to obtain access to comprehensive, in-home support services such as home care, palliative care, and hospice, the team at Shaw Cancer Center developed Shaw at Home, an oncology specific home and community-based palliative care program.

To date, Shaw at Home has served 123 unique patients and provided 1427 palliative care visits within the home/community and clinic; it also landed the program a 2025 Association of Cancer Care Centers (ACCC) Innovator Award. In anticipation of the ACCC 42nd National Oncology Conference this fall, ACCCBuzz spoke to Patricia Hardenbergh, MD, FASTRO, medical director at Shaw Cancer Center, to learn more about the program.

ACCCBuzz: How long has Shaw Cancer Center been an ACCC member?

Dr. Hardenbergh: We have been a member since 2018.

ACCCBuzz: What do you enjoy most about being an ACCC member? Are there specific programs, resources, or tools that you use at your cancer program?

Dr. Hardenbergh: I started my career in academia, where there was tremendous support in our department and our cancer center. Out in a community cancer center like Shaw, that support often looks very different. Having a group like ACCC that is specifically interested in the challenges and barriers faced by a community cancer center is so wonderful, and their support has afforded us so many opportunities and insights to better our program.

ACCCBuzz: What makes your cancer center unique?

Dr. Hardenbergh: We have an incredibly supportive and generous community. When I came to Shaw Cancer Center over 20 years ago, a group of 5 individuals came to me from the community and sat down with me on a monthly basis to ask how they could help. I had never experienced anything like that in academia.

A few months in, I had a patient whose diagnosis required him to get radiation treatment every day for 2 weeks. Our location is very rural, and this individual was a rancher who lived 2 hours away, so he was going to sleep in his car to be able to get treatment. That day, I went to the group and said, “I need you to build me a house.” At the time, we laughed, but 2 years later, we had a 12-bedroom house right next to the cancer center where our patients can stay during treatment. Our community raised the money, built it, and went through all the hoops that it took to put it together. And it’s still standing 15 years later. There are a lot of things that make us unique, but the way our community has stepped up over the years to provide support is an overarching component of Shaw Cancer Center’s success.

ACCCBuzz: It can be challenging for administrators and C-suite members to share a common language with clinicians and others who provide direct patient care. Can you share any tips you used to obtain buy-in and support for your innovation?

Dr. Hardenbergh: We certainly knew there was a need to enhance our palliative care offerings, but that need was exacerbated by COVID-19 and the years following. Our homecare and hospice were completely overwhelmed; there was a 40-patient waiting list and we simply couldn’t reach all the rural areas covered by our cancer center. Our needs were more than just end-of-life care, but providing support throughout treatment as well. Some treatments are more difficult to tolerate than others. For example, the patient who has head and neck cancer and is getting concurrent chemotherapy and radiation, while managing nutrition and hydration. Even though that patient is very likely to be cured, the actual treatment to achieve that cure is so difficult and requires so much support. That idea of not only providing high-quality treatment but also extensive support post-treatment was wrapped into our original vision for Shaw at Home.

At the time, we had the bare bones of a palliative care program, with 1 nurse practitioner who was also working on the medical oncology side. Rather than reinventing the wheel, we did a lot of research to find other programs that operated an oncology-specific palliative care team that was embedded within the oncology practice and extended beyond the clinic into homes. We came across the program Huntsman at Home at a cancer center in Utah, and though their structure differed greatly from our vision, we called them to discuss and gain insight into the development of their program.

When presenting all this to our C-suite, the most important things we did were gaining the confidence of our team members and persevering. Early on, we hit a wall when developing a sustainable business model, but we didn’t give up. We launched the Imagine campaign to discuss different areas of improvement at our cancer center for 5 Friday nights throughout the fall. There was no requirement for staff to attend, but we had an incredible response from our C-suite, nurses, and nurse practitioners, who were all passionate about making Shaw at Home work. My advice to other programs is to persevere, no matter how long it takes, until you get the support you need.

ACCCBuzz: ACCC President Una Hopkins, DNP, MSN, FNP-BC, NE-BC, RN, FACCC, centered her theme on Designing Oncology Care to Meet the Needs of a Growing Patient Population. A key component of that theme is Capacity Building at Scale, which was key to your innovation. Can you share any insights you’ve learned in this area?

Dr. Hardenbergh: We serve 5 different counties in rural Colorado, but we designed our launch of Shaw at Home to keep it within Eagle County for the first year. Our goal was to take this time to start small, gain experience, and learn the extent of what we could do without taking too many risks, like having our nurse practitioners drive an hour and a half away.

A unique aspect of our program is that our nurse practitioners working on the medical oncology side were really interested in being the bridge to the palliative care side. Now, patients aren’t meeting someone new when they enter into the end-of-life phase of care—the same nurse practitioner they’ve been seeing for years is coming to their home. Continuity of care was one of the pillars of the program. Being so small, we knew patients by name, so it was difficult to hand them off to other organizations. We feel strongly that utilizing staff that already knew the patient’s medical history, comorbidities, and treatment complications is a critical and beneficial element of our program. In the end, we hired 2 seasoned nurses and a scheduler to complete the team of existing nurse practitioners, chaplains, and social workers.