Brad Zebrack1, Karen Kayser2, Laura Sundstrom2, Sue Ann Savas2, Chris Henrickson2, Chiara Acquati2, Rebecca L Tamas2. 1. Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY. zebrack@umich.edu. 2. Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
Abstract
PURPOSE: The American College of Surgeons Commission on Cancer has mandated implementation of a systematic protocol for psychosocial distress screening and referral as a condition for cancer center accreditation beginning in 2015. Compliance with standards requires evidence that distress screening protocols are carried out as intended and result in appropriate referral and follow-up when indicated. The purpose of this study was to examine the fidelity of distress screening protocols at two tertiary cancer treatment centers. METHODS: A retrospective review and analysis of electronic medical records over a 12-week period examined clinic adherence to a prescribed distress screening protocol and responsiveness to patients whose scores on the National Comprehensive Cancer Network Distress Thermometer (DT) indicated clinically significant levels of distress requiring subsequent psychosocial contact. A weekly online survey assessed clinician perspectives on the acceptability of the protocol. RESULTS: Across clinics, rates of adherence to the distress screening protocol ranged from 47% to 73% of eligible patients. For patients indicating clinically significant distress (DT score ≥ 4), documentation of psychosocial contact or referral occurred, on average, 50% to 63% of the time, and was more likely to occur at one of two participating institutions when DT scores were high (DT score of 8 to 10). Clinician assessments of the protocol's utility in addressing patient concerns and responding to patient needs were generally positive. CONCLUSION: Systematic tracking of distress screening protocols is needed to demonstrate compliance with new standards of care and to demonstrate how well institutions are responding to their clinical obligation to address cancer patients' emotional and psychosocial needs.
PURPOSE: The American College of Surgeons Commission on Cancer has mandated implementation of a systematic protocol for psychosocial distress screening and referral as a condition for cancer center accreditation beginning in 2015. Compliance with standards requires evidence that distress screening protocols are carried out as intended and result in appropriate referral and follow-up when indicated. The purpose of this study was to examine the fidelity of distress screening protocols at two tertiary cancer treatment centers. METHODS: A retrospective review and analysis of electronic medical records over a 12-week period examined clinic adherence to a prescribed distress screening protocol and responsiveness to patients whose scores on the National Comprehensive Cancer Network Distress Thermometer (DT) indicated clinically significant levels of distress requiring subsequent psychosocial contact. A weekly online survey assessed clinician perspectives on the acceptability of the protocol. RESULTS: Across clinics, rates of adherence to the distress screening protocol ranged from 47% to 73% of eligible patients. For patients indicating clinically significant distress (DT score ≥ 4), documentation of psychosocial contact or referral occurred, on average, 50% to 63% of the time, and was more likely to occur at one of two participating institutions when DT scores were high (DT score of 8 to 10). Clinician assessments of the protocol's utility in addressing patient concerns and responding to patient needs were generally positive. CONCLUSION: Systematic tracking of distress screening protocols is needed to demonstrate compliance with new standards of care and to demonstrate how well institutions are responding to their clinical obligation to address cancerpatients' emotional and psychosocial needs.
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