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Published on: June 20, 2020
Development of an Evaluation Tool for Monitoring the Delivery of Psychosocial Care in Pediatric Oncology Settings
Kristin Foster1, Bethany Sadler2, Amy L Conrad3
1Department of Pediatrics, University of Iowa College of Nursing, Division of Hematology and Oncology, University of Iowa Stead Family Children's Hospital, Iowa City, IA 52242, USA.
Insights
A new program evaluation system was developed to improve psychosocial care for pediatric cancer patients. This system uses objective measures and a REDCap database to track progress toward 15 standards of care.
Area of Science:
- Pediatric Oncology
- Psychosocial Care
- Program Evaluation
Background:
- The University of Iowa Stead Family Children's Hospital (UI SFCH) established a Pediatric Psychosocial Oncology Program in 2019.
- The program aimed to implement 15 evidence-based Standards for Psychosocial Care for Children with Cancer and Families.
- Gaps in care and the need for improved progress toward these standards were identified by the clinical team.
Purpose of the Study:
- To create a program evaluation system with objective measures tailored to the UI SFCH setting.
- To address barriers such as staffing and cost in program development.
- To establish a framework for monitoring improvements in psychosocial care over time.
Main Methods:
- Development of institution-specific objective measures based on the Pediatric Psychosocial Standard of Care Institutional Assessment Tool.
- Implementation of a REDCap® database to facilitate structured chart reviews.
- Analysis of social work and provider biopsychosocial assessments using statistical methods (one-tailed t-test).
Main Results:
- A functional program evaluation system was created using a REDCap® database.
- The system allows for comprehensive evaluation of the implementation of 15 standards of psychosocial care.
- Objective measures were developed to monitor progress and identify areas for improvement.
Conclusions:
- The developed REDCap® database system enables efficient evaluation of the Pediatric Psychosocial Oncology Program.
- Future use of the database will support continuous quality improvement by identifying areas needing further attention.
- The system ensures comprehensive adherence to all 15 standards of psychosocial care for pediatric oncology patients and their families.
Abstract:
In January of 2019, the University of Iowa Stead Family Children's Hospital (UI SFCH) formalized their Pediatric Psychosocial Oncology Program by utilizing 15 evidence-based Standards for Psychosocial Care for Children with Cancer and Families as a foundation for program development. The psychosocial oncology clinical team members identified ongoing gaps in care and a need to improve progress toward achieving these standards. Reviewing and analyzing the Pediatric Psychosocial Standard of Care Institutional Assessment Tool further highlighted the need for program development but also demonstrated the need to design institutionally specific objective measures to monitor program improvements over time. The current project focused on the creation of a program evaluation system with objective measures specific to the UI SFCH practice setting. Barriers such as staffing and cost were identified and addressed. Additionally, a REDCap® database using a structured chart review as its foundation was initiated, which permitted the comprehensive evaluation of the standards of care at UI SFCH. The Matrix and Guidelines included in the Pediatric Psychosocial Standard of Care Institutional Assessment Tool comprised the framework to develop institution specific objective measurements for each standard of care. The objective measures of interest were social work assessments and provider biopsychosocial assessments. Data were exported and uploaded to a statistical program for data analysis. The statistical significance of percentage changes was evaluated with a one-tailed t-test; p values < 0.05 were considered significant. The development of this REDCap® database project allowed for the evaluation of the program's current efficiency in implementing the PSCPCC standards of care. Using the database in the future will allow psychosocial oncology team members to easily identify other areas for improvement and to ensure that all 15 standards of psychosocial care are being comprehensively addressed in the care of pediatric oncology patients and interactions with their families.
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