Preliminary evaluation of quality of psychosocial care indicators: Results from the Quality Oncology Practice Initiative (QOPI)

Abstract

6534 Background: To gauge the opportunity for improvements in psychosocial care, ASCO's QOPI program tested two new quality indicators in 2008. Similar to other QOPI indicators, these were presented as questions to be answered (yes/no) based on review of patient records: 1) was current emotional well-being assessed within one month of a first visit with a medical oncologist; and 2) was action taken for a patient identified as having a problem with emotional well-being. In addition to examining variability on these indicators, performance of assessments of pain (another QOPI indicator) and emotional well-being were directly compared. Methods: Practices participating in the Spring 2008 QOPI data collection round were included if they reported results for psychosocial care indicators with at least 40 patients. This criterion was met by 96 practices, which provided information on 9,045 patient records. Results: Across practices, rates of assessment of emotional well-being ranged from 0–100% (Mdn = 78%), with 27% of practices achieving rates < 50%. In contrast, rates of assessment of pain ranged from 12–100% (Mdn = 88%), with 9% of practices achieving rates < 50%. Mean rates of assessment of pain (83%) and emotional well-being (70%) differed significantly across practices (t = 4.61, p < 0.001). Problems in emotional well-being were documented in 10% of records. Among these records, rates of documentation of action taken ranged from 0–100% (Mdn = 73%, M = 72%), with 26% of practices achieving rates < 50%. Conclusions: Wide variability in the documentation of psychosocial care was evident among the practices surveyed, with at least 26% showing substantial opportunity for improvement (i.e., performance < 50%). Additional findings suggest that, to date, efforts to promote routine symptom assessment have been more successful for pain than for emotional well being. No significant financial relationships to disclose.