Article

The Veteran Symptom Assessment Screen (VSAS) as an Alternate for the National Comprehensive Cancer Network (NCNDT) Distress Thermometer

Abstract 13: 2016 AVAHO Meeting


 

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.

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