Do high symptom scores trigger clinical actions? An audit after implementing electronic symptom screening

Area of Science:

• Oncology
• Clinical Informatics
• Patient Symptom Management

Background:

• Standardized electronic symptom assessment aims to identify patient needs.
• Limited research exists on clinical processes for symptom management.
• This study investigates the link between symptom severity and clinical actions.

Purpose of the Study:

• To determine if higher symptom scores are associated with increased chart documentation.
• To examine if higher symptom scores lead to more symptom-specific clinical actions.
• To evaluate the clinical process of symptom management in cancer care.

Main Methods:

• Retrospective chart review of 912 cancer patient visits.
• Utilized the electronic Edmonton Symptom Assessment Scale (ESAS) for symptom screening.
• Analyzed pain and shortness of breath scores (0-10) and their association with documentation and actions within one week.

Main Results:

• Increased ESAS severity scores significantly correlated with higher documentation rates for pain and shortness of breath.
• Higher symptom scores showed a significant association with increased symptom-related clinical actions.
• Pain and shortness of breath were documented in 51.8% and 29.7% of visits, with actions in 16.9% and 3.9% respectively.

Conclusions:

• A positive association exists between higher symptom severity scores and increased documentation and clinical actions.
• Despite this association, clinical actions for severe symptoms were documented in a minority of patient visits.
• Findings suggest potential gaps in timely and adequate clinical response to severe symptoms in cancer patients.