Implementing psychosocial distress screening across a health system: Herding cats or herding cats?

Abstract

113 Background: With the American College of Surgeons Commission on Cancer 2015 Standards in hand, Penn Medicine embarked on a project to formulate an entity-wide plan for the provision of psychosocial distress screening. Identifying psychosocial distress and providing resources to meet those needs is an essential component of quality cancer care. Penn Medicine and the Abramson Cancer Center provided more than 91,000 chemotherapy treatments, 121,000 radiation treatments, and 14,000 proton therapy treatments in FY 15 in urban, suburban and rural settings with wide variations in resources. Methods: The establishment of the Psychosocial Distress Task Force was the key to the success of the project. Participants from multiple disciplines were invited from each facility including identified stakeholders and those with experience screening patients. After reviewing the literature, the task force set the agenda for the project including what tool to utilize for screening, when to screen, who will respond and what metrics would be evaluated. Results: Penn Medicine successfully developed a process for psychosocial distress screening across the health system by the 2015 deadline. The process includes screening all first return medical oncology patients for distress using the PHQ-4 and documenting the results in either the EMR or in the paper chart depending on the facility. The screening results then trigger a consult to social work where the patients are assessed using a standardized social work assessment developed by the task force for use by all oncology social workers across the system to standardize care. Conclusions: Given the scope of Penn Medicine oncology and the diversity of locations and staff models, formulating a plan for the provision of psychosocial distress screening presented a major challenge to the organization. This challenge was met through the establishment of a system-wide task force who planned and implemented distress screening across entity in a cohesive, coordinated way meeting the 2015 Standard.