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Implementing process improvements to enhance distress screening and management.

Nicole L Stout1,2, Crystal Street3, Patricia Policicchio3

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An enhanced Distress Thermometer (eDT) improved cancer patient distress screening and management. Integrating provider, system, and clinic improvements connected 100% of high-distress patients to specialty care, increasing screening compliance.

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Area of Science:

  • Oncology
  • Psycho-oncology
  • Healthcare Systems Improvement

Background:

  • Distress is common in cancer patients, yet management is suboptimal despite screening standards.
  • Existing distress screening tools lack comprehensive context for effective management.
  • Need for optimized distress management integrated into routine cancer care delivery.

Purpose of the Study:

  • To describe the development and deployment of an enhanced Distress Thermometer (eDT).
  • To highlight multi-level improvements (provider, system, clinic) for distress management.
  • To assess the feasibility, acceptability, and impact of the eDT intervention.

Main Methods:

  • Provider-level: Focus groups and surveys to identify problems and solutions for distress screening.
  • System-level: Electronic Health Record (EHR) infrastructure changes for automated referrals.
  • Clinic-level: Workflow adaptations to integrate eDT into routine care.

Main Results:

  • eDT was found feasible and acceptable by providers (n=30).
  • System changes ensured 100% of patients with moderate-to-severe distress were referred to specialty care.
  • Clinic workflow changes increased distress screening compliance from 85% to 96% within one year.

Conclusions:

  • The eDT enhances identification of referral pathways for distressed cancer patients.
  • Multi-level process interventions significantly improved distress screening and management outcomes.
  • This integrated approach offers a scalable model for improving distress care in oncology settings.