Psychosocial Distress Management in an Outpatient Oncology Clinic: A Quality Improvement Project
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Date
2024-05
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The Ohio State University
Abstract
People with cancer have a high prevalence of psychosocial distress. Distress affects treatment adherence, medical service utilization, quality of life, and mortality. Identifying distress through screening and referral to supportive services alleviates psychosocial distress and improves health outcomes. Despite the Commission on Cancer distress screening requirements for accreditation, compliance is variable. An evidence-based quality improvement project was implemented in an outpatient oncology clinic to improve distress screening for all new and established patients using an adapted version of the National Comprehensive Cancer Network Distress Thermometer and Problem List distress screening tool. The project also aimed to improve documentation on distress screening based on a pre- and post-chart audit. A learning module was developed, and the project was implemented over 6 weeks. A multidisciplinary team collaborated to identify workflow barriers to screening compliance and to improve the workflow process. The Practice & Process Improvement Model was used to ensure ongoing evaluation of the workflow to improve screening rates. Preliminary data showed distress screening was completed with only 65% of newly referred patients; established patients were not screened before this project. Screening rates post-implementation improved to 100% among both newly referred and established patients. Chart audits showed that clinical documentation of distress screening results improved. The multidisciplinary team reported that participation in this continuous quality improvement of distress screening and referrals increased their awareness of the importance of distress screening and improved their referral to appropriate resources.
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Keywords
Psychosocial distress screening, cancer, distress management, quality improvement, supportive care services, referral