Quality Improvement

Enhancing Health Psychology Services in Oncology


 

PURPOSE

This workforce project evaluated potential enhancement of health psychology services with the establishment of a dedicated and integrated psychooncology position at one VA.

BACKGROUND

Broad health psychology services have been offered across this VA healthcare system with some success (Bloor et al., 2017; Bloor et al., 2022). Previously, some services were enhanced when a dedicated psychology position was funded and integrated with the interdisciplinary pain team (Dadabeyev et al., 2019).

METHODS

We reviewed utilization of services with clinic data for a 4-month period prior to the new position, compared to the first 4-months the health psychologist integrated with Oncology. We also conducted a “perceptions of referring providers” survey, assessing Utility and Quality.

DATA ANALYSIS

For utilization of health psychology services, we explored descriptive statistics. An independent samples t-test was conducted to evaluate perceptions of the services’ Utility and Quality, comparing perceptions of referring providers across the healthcare system (Bloor et al., 2017) to Oncology providers’ perceptions when a dedicated psychologist became available.

RESULTS

For the first 4 months psychology services were dedicated to Oncology, 82 Veterans received 1 or more sessions for a total of 222 encounters compared to 44 Veterans receiving health psychology services for a total of 98 sessions in the 4-month period prior. Also, during the first 4-month period with integrated care, previously unavailable same-day services were offered to Veterans, ranging from 4-9 same-day sessions each week. For the referring providers’ survey, perceptions of Utility increased significantly from m=13.70 (SD=1.36) to m=14.90 (SD=0.32), t=2.76, (p-value=.0076).

IMPLICATIONS

These data suggest increased availability and usage of services, and enhanced perceptions of the Utility of health psychology services when funding for a dedicated position was implemented. Additional measures of service enhancement can be explored in the future to understand better the added value of integrated health psychology. This could explore improvement in distress and suicide risk screening, availability to identify and outreach to Veterans at risk, and/or enhancement for survivorship, prevention or other cancer care standards. Moreover, it is important to capture Veterans’ perceptions of services, including changes in mood, functioning and quality of life.

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