A patient newly diagnosed with cancer is often worried about more than upcoming tests and treatments.
Along with physical and emotional reactions to a cancer diagnosis, patients may ask questions such as, how do I tell my children? How can I take time off from work or school? How will this affect my finances?
Nurses, social workers and other care providers have always helped patients deal with these types of psychosocial issues, but Smilow Cancer Hospital staff are now using an emotional distress survey tool to help screen, track and respond to them.
"These tools are being used nationally because research has shown that cancer patients' psychosocial needs have not always been regularly screened and addressed," said Bonnie Indeck, manager, Oncology Social Work, Smilow.
As part of its accreditation by the American College of Surgeons Commission on Cancer, Smilow is required to use an emotional distress measurement tool, so in 2013 staff from different disciplines and areas formed a task force, led by Indeck, Stephanie Amport, Smilow quality and safety coordinator, and Matthew Burke, APRN, nurse practitioner, Melanoma and Renal Cell Carcinoma Team.
Once the tool and guidelines were finalized, a different task force worked with Information Technology Services to integrate it into Epic. The emotional distress survey tool was piloted in several Smilow departments before being rolled out in 2014 to all areas of the cancer hospital at York Street and Smilow Cancer Care Centers.
The survey asks new patients to rate on a scale of zero to 10 their level of distress around practical issues such as work/school and child care; emotional issues such as nervousness and depression; family issues such as dealing with a partner or children; and physical problems such as fatigue and pain.
A licensed care provider — nurse, social worker, physician or nurse practitioner — reviews survey responses with patients. A patient with a distress level of four or higher is referred to a social worker and any other appropriate care providers, who will comprehensively assess the patient's concerns and provide options for counseling, support groups, community agencies and other resources that can help. Patients with scores of eight or higher see a social worker immediately.
"We want to be proactive in addressing these psychosocial needs because they not only affect the patient, they can affect his or her treatment," Burke said. Already the emotional distress survey tool is yielding valuable information that helps care providers quickly hone in on patients' needs and can help improve the patient experience, Burke said.
Added Indeck, "It helps patients feel not only cared for, but cared about."
