Use of self-reporting outcomes to inform patient care.

Abstract

176 Background: Cancer Treatment Centers of America, Inc (CTCA) is a national network of hospitals that specialize in the treatment of patients fighting complex or advanced-stage cancer. The Symptom Inventory Tool (SIT) is an assessment tool that captures the patients’ perceived symptom burden for real-time clinical intervention, from the point of no intervention (baseline) and every 21 days or greater. The SIT is comprised of 27 questions utilizing the MD Anderson Symptom Inventory tool, a validated assessment instrument with eight questions added and a free text box by CTCA. The SIT became an integral part of patient care at CTCA beginning in 2012. Methods: Non-clinical stakeholders administer the SIT via an electronic tablet. Upon completion of the assessment, a trending graph known as Symptoms-at-a-Glance (SAG) report is auto populated and available to clinicians in the EHR or may be printed at the point of care. The SAG provides run graphs for each symptom including arrows identifying clinically relevant changes in score. An accompanying e-mail notification system was created for physicians to review specific symptoms of interest at a threshold of their choosing, and refer patients to other specialties deemed integral for the patient’s treatment plan. Results: The SIT assessment is utilized by the nurse as a starting point from which they can initiate a more pointed conversation with the patient including the need for appropriate intervention including follow-up with the oncologist and/or referral to a member of the extended integrative care team. The percentage of new and returning patients completing an assessment is at 94.94% and 84.81%, respectively, for patients (1/1/14-6/9/14) across CTCA suggesting this process is useful for both patient and clinicians. Patients comment that the time for self-reflection is a healthy exercise enabled by the user-friendly tablet. Clinicians value both the ease of administration/use as well as the ability to create a large data set for quality improvement. Conclusions: With a majority of new and returning patients participating in the SIT, the SAG report fully implemented into the EHR along with the use of an e-mail functionality, clinicians and physicians can now better manage symptom burden real time