Meyers K

Background: To best address the psychosocial concerns experienced by patients with cancer, the 2007 report of the IOM, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, described the importance of distress screening and identifying psychosocial needs to optimize the quality of the cancer care. This may be especially critical when treating the Veteran population, where psychosocial needs as a whole may be elevated compared to non-VA institutions. The NCCN distress thermometer screening tool is a commonly used, validated, and easily administered screen of distress (eg, Hoffman et al, 2004). However, challenges can arise in successful implementation, adherence, and responsiveness to the information gleaned from this screen (eg, Zebrack et al, 2015).

As an institution accredited by the commission on cancer, it is important to not only meet the distress screening standard (ie, assess and identify psychosocial needs) but to understand barriers to identifying psychosocial needs and to appropriately triage when psychosocial concerns are identified. Goals of this project were to understand challenges with distress screening, address barriers to distress screening, and improve quality of assessment and referrals following positive screens.

Results: At Hines VAMC, we rolled out distress screening in 2015 and 2016, with rates of screening administration increasing over the course of the first year. However, without continued monitoring and re-education, successful adherence decreased overtime. Additionally, of the 862 screens administered to date, 37% were found to be considered “positive.” We will discuss the various barriers and challenges associated with managing referrals to nonmedical providers.

Our team has identified several essential aspects of successful screening and follow-up including staff/nursing education, continued tracking and re-education over time, and establishing and maintaining relationships with psychosocial clinicians to best address these aspects of care and to optimize quality of cancer care overall. We will discuss the impact of the above interventions on adherence and responsiveness.

Background: To best address the psychosocial concerns experienced by patients with cancer, the 2007 report of the IOM, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, described the importance of distress screening and identifying psychosocial needs to optimize the quality of the cancer care. This may be especially critical when treating the Veteran population, where psychosocial needs as a whole may be elevated compared to non-VA institutions. The NCCN distress thermometer screening tool is a commonly used, validated, and easily administered screen of distress (eg, Hoffman et al, 2004). However, challenges can arise in successful implementation, adherence, and responsiveness to the information gleaned from this screen (eg, Zebrack et al, 2015).

As an institution accredited by the commission on cancer, it is important to not only meet the distress screening standard (ie, assess and identify psychosocial needs) but to understand barriers to identifying psychosocial needs and to appropriately triage when psychosocial concerns are identified. Goals of this project were to understand challenges with distress screening, address barriers to distress screening, and improve quality of assessment and referrals following positive screens.

Results: At Hines VAMC, we rolled out distress screening in 2015 and 2016, with rates of screening administration increasing over the course of the first year. However, without continued monitoring and re-education, successful adherence decreased overtime. Additionally, of the 862 screens administered to date, 37% were found to be considered “positive.” We will discuss the various barriers and challenges associated with managing referrals to nonmedical providers.

Our team has identified several essential aspects of successful screening and follow-up including staff/nursing education, continued tracking and re-education over time, and establishing and maintaining relationships with psychosocial clinicians to best address these aspects of care and to optimize quality of cancer care overall. We will discuss the impact of the above interventions on adherence and responsiveness.

Background: To best address the psychosocial concerns experienced by patients with cancer, the 2007 report of the IOM, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, described the importance of distress screening and identifying psychosocial needs to optimize the quality of the cancer care. This may be especially critical when treating the Veteran population, where psychosocial needs as a whole may be elevated compared to non-VA institutions. The NCCN distress thermometer screening tool is a commonly used, validated, and easily administered screen of distress (eg, Hoffman et al, 2004). However, challenges can arise in successful implementation, adherence, and responsiveness to the information gleaned from this screen (eg, Zebrack et al, 2015).

As an institution accredited by the commission on cancer, it is important to not only meet the distress screening standard (ie, assess and identify psychosocial needs) but to understand barriers to identifying psychosocial needs and to appropriately triage when psychosocial concerns are identified. Goals of this project were to understand challenges with distress screening, address barriers to distress screening, and improve quality of assessment and referrals following positive screens.

Results: At Hines VAMC, we rolled out distress screening in 2015 and 2016, with rates of screening administration increasing over the course of the first year. However, without continued monitoring and re-education, successful adherence decreased overtime. Additionally, of the 862 screens administered to date, 37% were found to be considered “positive.” We will discuss the various barriers and challenges associated with managing referrals to nonmedical providers.

Our team has identified several essential aspects of successful screening and follow-up including staff/nursing education, continued tracking and re-education over time, and establishing and maintaining relationships with psychosocial clinicians to best address these aspects of care and to optimize quality of cancer care overall. We will discuss the impact of the above interventions on adherence and responsiveness.