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National Comprehensive Cancer Network Distress Thermometer Versus Veteran Symptom Assessment Screen: Year in Review at the Cleveland VAMC
Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).
Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.
Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).
Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.
Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.
Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).
Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.
Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).
Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.
Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.
Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).
Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.
Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).
Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.
Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.
The Veteran Symptom Assessment Screen (VSAS) as an Alternate for the National Comprehensive Cancer Network (NCNDT) Distress Thermometer
Purpose: To utilize a distress screening tool that can be used across VAMCs that fulfills cancer center requirements and accreditation standards.
Background: The American College of Surgeon’s (ACOS) Commission on Cancer (COC), Standard 3.2 Distress Screening requires all new cancer diagnoses be screened at diagnosis and at pivotal points across the cancer care continuum. The Louis Stokes Cleveland VAMC (LSCVAMC) used the NCCN DT from May 2012 through March 2016. Collaborating with the Durham VAMC, the LSCVAMC began to pilot the VSAS screening tool in place of the NCCN DT. This initiative was an attempt to use 1 tool that could satisfy both ACOS COC accreditation standards as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification.
Methods: An interdisciplinary team composed of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse and the Cancer Center Program Administrator gathered to compare elements of both the NCCN DT and the VSAS tool. Social elements of distress related to transportation, housing and insurance deemed important to our veteran population were incorporated into the existing VSAS tool.
Data Analysis: During March through June 2016 there have been 47 VSAS tools completed on 47 unique patients. Nursing staff administer, document, and order applicable consults for the screening process. The time required to complete the screen is approximately 2-4 minutes depending on the complexity of the patient. Preliminary data regarding specific elements of the VSAS will be forthcoming at the time of poster presentation.
Results: Patients with a new diagnosis of cancer were asked to complete the form at their initial visit. Initial results from the team piloting the VSAS found that the tool actually allowed providers to hone in on more of the areas that were causing the Veteran the most distress. Whereas, with DT only having 1 thermometer made narrowing down what was causing the most distress more difficult.
Implications: Finding tools that can be implemented across VA facilities for both COC and QOPI initiatives will streamline processes and allow for multicenter data collection benefiting the VA as a whole and decreasing variability in cancer care between facilities.
Purpose: To utilize a distress screening tool that can be used across VAMCs that fulfills cancer center requirements and accreditation standards.
Background: The American College of Surgeon’s (ACOS) Commission on Cancer (COC), Standard 3.2 Distress Screening requires all new cancer diagnoses be screened at diagnosis and at pivotal points across the cancer care continuum. The Louis Stokes Cleveland VAMC (LSCVAMC) used the NCCN DT from May 2012 through March 2016. Collaborating with the Durham VAMC, the LSCVAMC began to pilot the VSAS screening tool in place of the NCCN DT. This initiative was an attempt to use 1 tool that could satisfy both ACOS COC accreditation standards as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification.
Methods: An interdisciplinary team composed of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse and the Cancer Center Program Administrator gathered to compare elements of both the NCCN DT and the VSAS tool. Social elements of distress related to transportation, housing and insurance deemed important to our veteran population were incorporated into the existing VSAS tool.
Data Analysis: During March through June 2016 there have been 47 VSAS tools completed on 47 unique patients. Nursing staff administer, document, and order applicable consults for the screening process. The time required to complete the screen is approximately 2-4 minutes depending on the complexity of the patient. Preliminary data regarding specific elements of the VSAS will be forthcoming at the time of poster presentation.
Results: Patients with a new diagnosis of cancer were asked to complete the form at their initial visit. Initial results from the team piloting the VSAS found that the tool actually allowed providers to hone in on more of the areas that were causing the Veteran the most distress. Whereas, with DT only having 1 thermometer made narrowing down what was causing the most distress more difficult.
Implications: Finding tools that can be implemented across VA facilities for both COC and QOPI initiatives will streamline processes and allow for multicenter data collection benefiting the VA as a whole and decreasing variability in cancer care between facilities.
Purpose: To utilize a distress screening tool that can be used across VAMCs that fulfills cancer center requirements and accreditation standards.
Background: The American College of Surgeon’s (ACOS) Commission on Cancer (COC), Standard 3.2 Distress Screening requires all new cancer diagnoses be screened at diagnosis and at pivotal points across the cancer care continuum. The Louis Stokes Cleveland VAMC (LSCVAMC) used the NCCN DT from May 2012 through March 2016. Collaborating with the Durham VAMC, the LSCVAMC began to pilot the VSAS screening tool in place of the NCCN DT. This initiative was an attempt to use 1 tool that could satisfy both ACOS COC accreditation standards as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification.
Methods: An interdisciplinary team composed of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse and the Cancer Center Program Administrator gathered to compare elements of both the NCCN DT and the VSAS tool. Social elements of distress related to transportation, housing and insurance deemed important to our veteran population were incorporated into the existing VSAS tool.
Data Analysis: During March through June 2016 there have been 47 VSAS tools completed on 47 unique patients. Nursing staff administer, document, and order applicable consults for the screening process. The time required to complete the screen is approximately 2-4 minutes depending on the complexity of the patient. Preliminary data regarding specific elements of the VSAS will be forthcoming at the time of poster presentation.
Results: Patients with a new diagnosis of cancer were asked to complete the form at their initial visit. Initial results from the team piloting the VSAS found that the tool actually allowed providers to hone in on more of the areas that were causing the Veteran the most distress. Whereas, with DT only having 1 thermometer made narrowing down what was causing the most distress more difficult.
Implications: Finding tools that can be implemented across VA facilities for both COC and QOPI initiatives will streamline processes and allow for multicenter data collection benefiting the VA as a whole and decreasing variability in cancer care between facilities.