Background and Context:
Establishing supportive care screening to identify and manage supportive care needs has been a focus for cancer reform in Victoria. Screening has been underway since 2010. The NCCN Distress Thermometer and Problem Checklist (DT) was selected and approval obtained. State-wide monitoring currently comprises retrospective record audits noting the presence of a documented supportive care screen. Local monitoring varies across the state. In 2013 it was determined that a standardised state-wide review of the identification and management of supportive care needs was required.
Aim:
Pilot a state-wide process for capturing supportive care activity using the DT.
Increase understanding of the distress, needs and management of cancer patients’ supportive care needs across Victoria.
Investigate how this information can be used by health services and practitioners to understand and improve the management of supportive care needs in the cancer population.
Strategy/Tactics:
A state-wide retrospective audit of over 2000 screens on a sample of the 2013 screened population was undertaken. All items on the DT were collected and additional information about the patient, their cancer, treatment, discussion about problems identified and referrals.
Programme/Policy Process:
Providing optimal cancer care: Supportive care policy for Victoria
Outcomes/What was learned:
The application of a state-wide process for capturing supportive care activity is achievable. For the first time there is a clear picture of the screened cancer population across the state. Findings included tumour types most commonly screened (breast, colorectal, lung) and those that are less likely to be screened (skin, gynaecological, genitourinary); cancer units where patients are most likely to be screened (day oncology); ratio of distress scores and problems identified; and the action taken following completion of the screen. It is anticipated that these audit results will be used to develop state-wide approaches to address identified gaps in service.