Hertz C

Purpose: An Innovation Network Spark award was received to develop “My Chemo Calendar,” a tool aimed at providing veterans with easy to understand critical information (eg drug name, schedule, side effects), to optimize the benefits of their oral anticancer drugs (OADs). Using a human-centered design approach, we are first obtaining insight from patients and providers on tools (including “my Chemo Calendar”) and strategies that may improve experiences with OADs.

Background: OADs often have complex dosing schedules, toxicity risk, and special handling precautions. Best tools and practices for ensuring safe and effective care for veterans who are prescribed OADs are not yet well established.

Methods: Surveys, focus groups, and semi-structured interviews are being conducted with patients and providers. Topics included: OAD education and knowledge, medication handling and adherence, and symptom management.

Data Analysis: Descriptive statistics will be used to summarize the survey data. Audio files from focus groups and semi-structured interviews will be transcribed and analyzed using NVivo.

Results: To date, data has been collected from two patients and eighteen oncology care providers. Both patients were ‘very satisfied’ with the information they received to successfully and safely take their OADs. They preferred to receive information from multiple sources (eg physician, internet, hand-outs). The majority of providers reported that they never/rarely/sometimes spoke about digesting an OAD with/without food, necessary diet modifications (e.g. no grapefruit), missed doses, medication storage temperatures, and refills. Most usually spoke about side effects, timing (eg morning), adverse effects, phone number to report side effects, and reporting concerning symptoms. Most were not/slightly/moderately confident that the patients were receiving all the necessary instructions to use the OAD properly. The oncology pharmacist was identified as the most appropriate oncology team member to provide patient education. Although, it was noted that it would be best for patients to receive information at various touch points from different team members. The concept of “My Chemo Calendar” was well received but how best to integrate it into care was unclear.

Implications: Data collection and analysis is still ongoing. This information will be used create and pilot new strategies and tools to improve experiences with OADs.

Purpose: An Innovation Network Spark award was received to develop “My Chemo Calendar,” a tool aimed at providing veterans with easy to understand critical information (eg drug name, schedule, side effects), to optimize the benefits of their oral anticancer drugs (OADs). Using a human-centered design approach, we are first obtaining insight from patients and providers on tools (including “my Chemo Calendar”) and strategies that may improve experiences with OADs.

Background: OADs often have complex dosing schedules, toxicity risk, and special handling precautions. Best tools and practices for ensuring safe and effective care for veterans who are prescribed OADs are not yet well established.

Methods: Surveys, focus groups, and semi-structured interviews are being conducted with patients and providers. Topics included: OAD education and knowledge, medication handling and adherence, and symptom management.

Data Analysis: Descriptive statistics will be used to summarize the survey data. Audio files from focus groups and semi-structured interviews will be transcribed and analyzed using NVivo.

Results: To date, data has been collected from two patients and eighteen oncology care providers. Both patients were ‘very satisfied’ with the information they received to successfully and safely take their OADs. They preferred to receive information from multiple sources (eg physician, internet, hand-outs). The majority of providers reported that they never/rarely/sometimes spoke about digesting an OAD with/without food, necessary diet modifications (e.g. no grapefruit), missed doses, medication storage temperatures, and refills. Most usually spoke about side effects, timing (eg morning), adverse effects, phone number to report side effects, and reporting concerning symptoms. Most were not/slightly/moderately confident that the patients were receiving all the necessary instructions to use the OAD properly. The oncology pharmacist was identified as the most appropriate oncology team member to provide patient education. Although, it was noted that it would be best for patients to receive information at various touch points from different team members. The concept of “My Chemo Calendar” was well received but how best to integrate it into care was unclear.

Implications: Data collection and analysis is still ongoing. This information will be used create and pilot new strategies and tools to improve experiences with OADs.

Purpose: An Innovation Network Spark award was received to develop “My Chemo Calendar,” a tool aimed at providing veterans with easy to understand critical information (eg drug name, schedule, side effects), to optimize the benefits of their oral anticancer drugs (OADs). Using a human-centered design approach, we are first obtaining insight from patients and providers on tools (including “my Chemo Calendar”) and strategies that may improve experiences with OADs.

Background: OADs often have complex dosing schedules, toxicity risk, and special handling precautions. Best tools and practices for ensuring safe and effective care for veterans who are prescribed OADs are not yet well established.

Methods: Surveys, focus groups, and semi-structured interviews are being conducted with patients and providers. Topics included: OAD education and knowledge, medication handling and adherence, and symptom management.

Data Analysis: Descriptive statistics will be used to summarize the survey data. Audio files from focus groups and semi-structured interviews will be transcribed and analyzed using NVivo.

Results: To date, data has been collected from two patients and eighteen oncology care providers. Both patients were ‘very satisfied’ with the information they received to successfully and safely take their OADs. They preferred to receive information from multiple sources (eg physician, internet, hand-outs). The majority of providers reported that they never/rarely/sometimes spoke about digesting an OAD with/without food, necessary diet modifications (e.g. no grapefruit), missed doses, medication storage temperatures, and refills. Most usually spoke about side effects, timing (eg morning), adverse effects, phone number to report side effects, and reporting concerning symptoms. Most were not/slightly/moderately confident that the patients were receiving all the necessary instructions to use the OAD properly. The oncology pharmacist was identified as the most appropriate oncology team member to provide patient education. Although, it was noted that it would be best for patients to receive information at various touch points from different team members. The concept of “My Chemo Calendar” was well received but how best to integrate it into care was unclear.

Implications: Data collection and analysis is still ongoing. This information will be used create and pilot new strategies and tools to improve experiences with OADs.

Background: To best address the psychosocial concerns experienced by patients with cancer, the 2007 report of the IOM, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, described the importance of distress screening and identifying psychosocial needs to optimize the quality of the cancer care. This may be especially critical when treating the Veteran population, where psychosocial needs as a whole may be elevated compared to non-VA institutions. The NCCN distress thermometer screening tool is a commonly used, validated, and easily administered screen of distress (eg, Hoffman et al, 2004). However, challenges can arise in successful implementation, adherence, and responsiveness to the information gleaned from this screen (eg, Zebrack et al, 2015).

As an institution accredited by the commission on cancer, it is important to not only meet the distress screening standard (ie, assess and identify psychosocial needs) but to understand barriers to identifying psychosocial needs and to appropriately triage when psychosocial concerns are identified. Goals of this project were to understand challenges with distress screening, address barriers to distress screening, and improve quality of assessment and referrals following positive screens.

Results: At Hines VAMC, we rolled out distress screening in 2015 and 2016, with rates of screening administration increasing over the course of the first year. However, without continued monitoring and re-education, successful adherence decreased overtime. Additionally, of the 862 screens administered to date, 37% were found to be considered “positive.” We will discuss the various barriers and challenges associated with managing referrals to nonmedical providers.

Our team has identified several essential aspects of successful screening and follow-up including staff/nursing education, continued tracking and re-education over time, and establishing and maintaining relationships with psychosocial clinicians to best address these aspects of care and to optimize quality of cancer care overall. We will discuss the impact of the above interventions on adherence and responsiveness.

Background: To best address the psychosocial concerns experienced by patients with cancer, the 2007 report of the IOM, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, described the importance of distress screening and identifying psychosocial needs to optimize the quality of the cancer care. This may be especially critical when treating the Veteran population, where psychosocial needs as a whole may be elevated compared to non-VA institutions. The NCCN distress thermometer screening tool is a commonly used, validated, and easily administered screen of distress (eg, Hoffman et al, 2004). However, challenges can arise in successful implementation, adherence, and responsiveness to the information gleaned from this screen (eg, Zebrack et al, 2015).

As an institution accredited by the commission on cancer, it is important to not only meet the distress screening standard (ie, assess and identify psychosocial needs) but to understand barriers to identifying psychosocial needs and to appropriately triage when psychosocial concerns are identified. Goals of this project were to understand challenges with distress screening, address barriers to distress screening, and improve quality of assessment and referrals following positive screens.

Results: At Hines VAMC, we rolled out distress screening in 2015 and 2016, with rates of screening administration increasing over the course of the first year. However, without continued monitoring and re-education, successful adherence decreased overtime. Additionally, of the 862 screens administered to date, 37% were found to be considered “positive.” We will discuss the various barriers and challenges associated with managing referrals to nonmedical providers.

Our team has identified several essential aspects of successful screening and follow-up including staff/nursing education, continued tracking and re-education over time, and establishing and maintaining relationships with psychosocial clinicians to best address these aspects of care and to optimize quality of cancer care overall. We will discuss the impact of the above interventions on adherence and responsiveness.

Background: To best address the psychosocial concerns experienced by patients with cancer, the 2007 report of the IOM, Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs, described the importance of distress screening and identifying psychosocial needs to optimize the quality of the cancer care. This may be especially critical when treating the Veteran population, where psychosocial needs as a whole may be elevated compared to non-VA institutions. The NCCN distress thermometer screening tool is a commonly used, validated, and easily administered screen of distress (eg, Hoffman et al, 2004). However, challenges can arise in successful implementation, adherence, and responsiveness to the information gleaned from this screen (eg, Zebrack et al, 2015).

As an institution accredited by the commission on cancer, it is important to not only meet the distress screening standard (ie, assess and identify psychosocial needs) but to understand barriers to identifying psychosocial needs and to appropriately triage when psychosocial concerns are identified. Goals of this project were to understand challenges with distress screening, address barriers to distress screening, and improve quality of assessment and referrals following positive screens.

Results: At Hines VAMC, we rolled out distress screening in 2015 and 2016, with rates of screening administration increasing over the course of the first year. However, without continued monitoring and re-education, successful adherence decreased overtime. Additionally, of the 862 screens administered to date, 37% were found to be considered “positive.” We will discuss the various barriers and challenges associated with managing referrals to nonmedical providers.

Our team has identified several essential aspects of successful screening and follow-up including staff/nursing education, continued tracking and re-education over time, and establishing and maintaining relationships with psychosocial clinicians to best address these aspects of care and to optimize quality of cancer care overall. We will discuss the impact of the above interventions on adherence and responsiveness.