Smith J

Background: The Comprehensive Cancer Program held a community Colorectal Cancer Awareness Fair on March 5, 2019 at the VAMC. The goal was to increase awareness of Colorectal Cancer and to engage veterans in educational opportunities about Colorectal Cancer.

Methods: The VAMC purchased an in atable “Megacolon” for veterans to walk through guided by nurses from the GI department. Cubicles were set-up for nursing education sessions, a provider station, a scheduling station, and a colonoscope table. A video loop “Before and After Colonoscopy” by Mechanisms in Medicine, Inc. (Thornhill, Ontario, Canada) played continuously in the waiting area by the provider and nurse’s cubicles. Providers in the GI department offered 2 educational presentations: “How to Stop Colon Cancer Before It Starts” by Carol Macaron, MD; and “Colonoscopy: The Good, Bad, and Ugly” by Edith Ho, MD. Additional education information was provided at staffed tables from VA General Surgery, GI, MOVE! Nutrition & Food Services, and Smoking Cessation. Also, in attendance were Crohn’s and Colitis Foundation, and the American Cancer Society. External Affairs advertised the fair on Facebook and Twitter. Medical Media created publicity posters and event flyers.

Results: The event was attended by 244 people—68 veterans, 170 employees, and 6 guests. Six colonoscopies were scheduled onsite. At least 7 veterans had questions regarding their colonoscopy surveillance in which reminder dates were given.

Background: The Comprehensive Cancer Program held a community Colorectal Cancer Awareness Fair on March 5, 2019 at the VAMC. The goal was to increase awareness of Colorectal Cancer and to engage veterans in educational opportunities about Colorectal Cancer.

Methods: The VAMC purchased an in atable “Megacolon” for veterans to walk through guided by nurses from the GI department. Cubicles were set-up for nursing education sessions, a provider station, a scheduling station, and a colonoscope table. A video loop “Before and After Colonoscopy” by Mechanisms in Medicine, Inc. (Thornhill, Ontario, Canada) played continuously in the waiting area by the provider and nurse’s cubicles. Providers in the GI department offered 2 educational presentations: “How to Stop Colon Cancer Before It Starts” by Carol Macaron, MD; and “Colonoscopy: The Good, Bad, and Ugly” by Edith Ho, MD. Additional education information was provided at staffed tables from VA General Surgery, GI, MOVE! Nutrition & Food Services, and Smoking Cessation. Also, in attendance were Crohn’s and Colitis Foundation, and the American Cancer Society. External Affairs advertised the fair on Facebook and Twitter. Medical Media created publicity posters and event flyers.

Results: The event was attended by 244 people—68 veterans, 170 employees, and 6 guests. Six colonoscopies were scheduled onsite. At least 7 veterans had questions regarding their colonoscopy surveillance in which reminder dates were given.

Background: The Comprehensive Cancer Program held a community Colorectal Cancer Awareness Fair on March 5, 2019 at the VAMC. The goal was to increase awareness of Colorectal Cancer and to engage veterans in educational opportunities about Colorectal Cancer.

Methods: The VAMC purchased an in atable “Megacolon” for veterans to walk through guided by nurses from the GI department. Cubicles were set-up for nursing education sessions, a provider station, a scheduling station, and a colonoscope table. A video loop “Before and After Colonoscopy” by Mechanisms in Medicine, Inc. (Thornhill, Ontario, Canada) played continuously in the waiting area by the provider and nurse’s cubicles. Providers in the GI department offered 2 educational presentations: “How to Stop Colon Cancer Before It Starts” by Carol Macaron, MD; and “Colonoscopy: The Good, Bad, and Ugly” by Edith Ho, MD. Additional education information was provided at staffed tables from VA General Surgery, GI, MOVE! Nutrition & Food Services, and Smoking Cessation. Also, in attendance were Crohn’s and Colitis Foundation, and the American Cancer Society. External Affairs advertised the fair on Facebook and Twitter. Medical Media created publicity posters and event flyers.

Results: The event was attended by 244 people—68 veterans, 170 employees, and 6 guests. Six colonoscopies were scheduled onsite. At least 7 veterans had questions regarding their colonoscopy surveillance in which reminder dates were given.

Purpose/Rationale: Our Minneapolis VA Healthcare System (MVAHCS) team developed a self-management symptom program using the existing Annie Mobile Messaging System platform that was designed to be userfriendly for Veterans. We are currently determining which patients with advanced cancer might benefit most from the system. Here we describe early results from this program.

Background: Symptom monitoring programs using electronic communications platforms in patients with advanced solid tumors undergoing routine outpatient chemotherapy has resulted in benefits such as improved quality of life, improved survival, and reduced Emergency Room (ER) usage.

Methods: We created a symptom management protocol in conjunction with the Annie Program Team. Patients are sent text messages twice daily Monday through Friday, and they are asked to rate the following symptoms with a severity scale of 0-4 (absent, mild, moderate, severe, or disabling): Nausea/vomiting, mouth sores, fatigue, trouble breathing, appetite, constipation, diarrhea, numbness/tingling, and pain. In addition, patients are asked whether they have had a fever or not. Based on the patient response, the patient receives an automated, corresponding text back. The text may provide positive affirmation that they are doing well, give them education, refer them to an educational hyperlink, ask them to call a direct number to the clinic, or report directly to the ER.

Results: We have currently enrolled 5 patients in the program through screening new patient consults or those referred for chemotherapy education. There have not been any calls to the clinic or visits to the ER to date. Initial evaluation of the program via survey found no technology challenges and patients have been very positive about the program, including ease of use, appreciation of messages that validated when they were doing well, empowerment of self-management, and utilization of the texting advice.

Conclusions: Development and introduction of the MVAHCS Mobile Messaging System for Self-Management of Chemotherapy Symptoms has been completed. Early evaluation has not revealed any major concerns. We will continue to introduce this technology to patients undergoing chemotherapy and will further assess the feasibility and efficacy of this novel VA program.

Purpose/Rationale: Our Minneapolis VA Healthcare System (MVAHCS) team developed a self-management symptom program using the existing Annie Mobile Messaging System platform that was designed to be userfriendly for Veterans. We are currently determining which patients with advanced cancer might benefit most from the system. Here we describe early results from this program.

Background: Symptom monitoring programs using electronic communications platforms in patients with advanced solid tumors undergoing routine outpatient chemotherapy has resulted in benefits such as improved quality of life, improved survival, and reduced Emergency Room (ER) usage.

Methods: We created a symptom management protocol in conjunction with the Annie Program Team. Patients are sent text messages twice daily Monday through Friday, and they are asked to rate the following symptoms with a severity scale of 0-4 (absent, mild, moderate, severe, or disabling): Nausea/vomiting, mouth sores, fatigue, trouble breathing, appetite, constipation, diarrhea, numbness/tingling, and pain. In addition, patients are asked whether they have had a fever or not. Based on the patient response, the patient receives an automated, corresponding text back. The text may provide positive affirmation that they are doing well, give them education, refer them to an educational hyperlink, ask them to call a direct number to the clinic, or report directly to the ER.

Results: We have currently enrolled 5 patients in the program through screening new patient consults or those referred for chemotherapy education. There have not been any calls to the clinic or visits to the ER to date. Initial evaluation of the program via survey found no technology challenges and patients have been very positive about the program, including ease of use, appreciation of messages that validated when they were doing well, empowerment of self-management, and utilization of the texting advice.

Conclusions: Development and introduction of the MVAHCS Mobile Messaging System for Self-Management of Chemotherapy Symptoms has been completed. Early evaluation has not revealed any major concerns. We will continue to introduce this technology to patients undergoing chemotherapy and will further assess the feasibility and efficacy of this novel VA program.

Purpose/Rationale: Our Minneapolis VA Healthcare System (MVAHCS) team developed a self-management symptom program using the existing Annie Mobile Messaging System platform that was designed to be userfriendly for Veterans. We are currently determining which patients with advanced cancer might benefit most from the system. Here we describe early results from this program.

Background: Symptom monitoring programs using electronic communications platforms in patients with advanced solid tumors undergoing routine outpatient chemotherapy has resulted in benefits such as improved quality of life, improved survival, and reduced Emergency Room (ER) usage.

Methods: We created a symptom management protocol in conjunction with the Annie Program Team. Patients are sent text messages twice daily Monday through Friday, and they are asked to rate the following symptoms with a severity scale of 0-4 (absent, mild, moderate, severe, or disabling): Nausea/vomiting, mouth sores, fatigue, trouble breathing, appetite, constipation, diarrhea, numbness/tingling, and pain. In addition, patients are asked whether they have had a fever or not. Based on the patient response, the patient receives an automated, corresponding text back. The text may provide positive affirmation that they are doing well, give them education, refer them to an educational hyperlink, ask them to call a direct number to the clinic, or report directly to the ER.

Results: We have currently enrolled 5 patients in the program through screening new patient consults or those referred for chemotherapy education. There have not been any calls to the clinic or visits to the ER to date. Initial evaluation of the program via survey found no technology challenges and patients have been very positive about the program, including ease of use, appreciation of messages that validated when they were doing well, empowerment of self-management, and utilization of the texting advice.

Conclusions: Development and introduction of the MVAHCS Mobile Messaging System for Self-Management of Chemotherapy Symptoms has been completed. Early evaluation has not revealed any major concerns. We will continue to introduce this technology to patients undergoing chemotherapy and will further assess the feasibility and efficacy of this novel VA program.

Purpose: A multiphased QI project to increase multidisciplinary team member (social work, dietician, mental health and palliative care) visits for patients with stage IV lung cancer receiving antineoplastic therapy.

Background: The Commission on Cancer program standards require an active multidisciplinary team to meet the needs of the patient. Prior to the addition of oncology navigators at the Minneapolis VA, patients received supportive services through consults placed by the oncologist, infusion clinic nurses or patient requests. Patients were not receiving care from these disciplines for a variety of reasons, including lack of a standardized process to trigger the initiation of a consult, physicians focusing on antineoplastic therapy, lack of room space in the clinic, and the stigma associated with mental health and palliative care to the layperson. It was thought that navigators may be able to assume the role of initiating the consults and coordinating the visits because they typically meet with each patient for chemo education.

Methods: The ACCESS database used to track oncology consults was reviewed for stage IV lung cancer patients receiving parental antineoplastic treatment from January 2015 through April 2017. Patients transferring care before the completion of therapy were excluded. Charts were reviewed to determine time from consult to therapy, visits with a social worker, dietician, mental health provider and palliative care consults. A contact included any visit both inpatient or outpatient during the treatment period.

Results: There were 191 lung cancer patients, 78 met the inclusion criteria. Ninety percent (70/78) of patients had contact with a navigator. 76% of the patients received palliative care, 69% contact with a social worker, 39% received a mental health provider visit and 64% received
a consult with a dietician.

Conclusions: It is feasible for a nurse navigator to coordinate visits among multiple specialties. Coordinating the visits in the infusion center leads to increased utilization of the specialty services, freed up rooms the provider clinic and normalized the inclusion of mental health and palliative care early in the treatment course.

Purpose: A multiphased QI project to increase multidisciplinary team member (social work, dietician, mental health and palliative care) visits for patients with stage IV lung cancer receiving antineoplastic therapy.

Background: The Commission on Cancer program standards require an active multidisciplinary team to meet the needs of the patient. Prior to the addition of oncology navigators at the Minneapolis VA, patients received supportive services through consults placed by the oncologist, infusion clinic nurses or patient requests. Patients were not receiving care from these disciplines for a variety of reasons, including lack of a standardized process to trigger the initiation of a consult, physicians focusing on antineoplastic therapy, lack of room space in the clinic, and the stigma associated with mental health and palliative care to the layperson. It was thought that navigators may be able to assume the role of initiating the consults and coordinating the visits because they typically meet with each patient for chemo education.

Methods: The ACCESS database used to track oncology consults was reviewed for stage IV lung cancer patients receiving parental antineoplastic treatment from January 2015 through April 2017. Patients transferring care before the completion of therapy were excluded. Charts were reviewed to determine time from consult to therapy, visits with a social worker, dietician, mental health provider and palliative care consults. A contact included any visit both inpatient or outpatient during the treatment period.

Results: There were 191 lung cancer patients, 78 met the inclusion criteria. Ninety percent (70/78) of patients had contact with a navigator. 76% of the patients received palliative care, 69% contact with a social worker, 39% received a mental health provider visit and 64% received
a consult with a dietician.

Conclusions: It is feasible for a nurse navigator to coordinate visits among multiple specialties. Coordinating the visits in the infusion center leads to increased utilization of the specialty services, freed up rooms the provider clinic and normalized the inclusion of mental health and palliative care early in the treatment course.

Purpose: A multiphased QI project to increase multidisciplinary team member (social work, dietician, mental health and palliative care) visits for patients with stage IV lung cancer receiving antineoplastic therapy.

Background: The Commission on Cancer program standards require an active multidisciplinary team to meet the needs of the patient. Prior to the addition of oncology navigators at the Minneapolis VA, patients received supportive services through consults placed by the oncologist, infusion clinic nurses or patient requests. Patients were not receiving care from these disciplines for a variety of reasons, including lack of a standardized process to trigger the initiation of a consult, physicians focusing on antineoplastic therapy, lack of room space in the clinic, and the stigma associated with mental health and palliative care to the layperson. It was thought that navigators may be able to assume the role of initiating the consults and coordinating the visits because they typically meet with each patient for chemo education.

Methods: The ACCESS database used to track oncology consults was reviewed for stage IV lung cancer patients receiving parental antineoplastic treatment from January 2015 through April 2017. Patients transferring care before the completion of therapy were excluded. Charts were reviewed to determine time from consult to therapy, visits with a social worker, dietician, mental health provider and palliative care consults. A contact included any visit both inpatient or outpatient during the treatment period.

Results: There were 191 lung cancer patients, 78 met the inclusion criteria. Ninety percent (70/78) of patients had contact with a navigator. 76% of the patients received palliative care, 69% contact with a social worker, 39% received a mental health provider visit and 64% received
a consult with a dietician.

Conclusions: It is feasible for a nurse navigator to coordinate visits among multiple specialties. Coordinating the visits in the infusion center leads to increased utilization of the specialty services, freed up rooms the provider clinic and normalized the inclusion of mental health and palliative care early in the treatment course.

Purpose: To improve access to specialty care for Veterans with a cancer concern and to improve communication among providers.

Background: Providers at the Cleveland VA Medical Center (CVAMC) voiced concerns that the process for Veterans with a cancer concern was fragmented, leading to potential delays in cancer diagnosis. The CVAMC developed an innovative process for the Cancer Fast Track Econsult (CFTE-C) to assist providers with expediting care for Veterans with a cancer concern. This process aims to improve communication between primary and specialty care providers, expedite pre-cancer workups, and allow more meaningful face to face first oncology specialty visits.

Methods: The E-consult is initiated by a primary care provider (PCP) in CPRS. After entering the CFTE-C an oncologist triages the consult to determine workup needed. The care coordinator (CC) ensures implementation of the plan of care and tracks its progression. This is done by the CC entering each Veteran into the Task Tracker (TT), a smart calendar that is used for communication and seamless coordination for selected Veterans. The CC continuously monitors the progression of diagnostic testing to ensure timeliness and identify delays. During the diagnostic process, the CC communicates the process to the PCP in CPRS. After cancer is confirmed or ruled out the CC discusses treatment plan with oncologist, documents in CPRS and notifies PCP.

Results: Since July 2015 there have been a total 145 veterans that have been referred to the CFTE-C. The average time from consultation to first action is 3 days. There is an average of about 6 CFTE-C consults monthly.

Implications: The CFTE-C process of using the TT allows the CC to monitor the Veterans workup and identify delays and barriers to care. The CC assists in eliminating any barriers or delays identified. The CFTE-C is underutilized by PCP’s and efforts are underway to improving utilization
by identifying a PCP champion in the outpatient clinics. There is also a need for clear measures of timeliness of care. Templated notes are in production to allow for clear tracking of the entire process including a clear handoff to PCP or referring provider.

Purpose: To improve access to specialty care for Veterans with a cancer concern and to improve communication among providers.

Background: Providers at the Cleveland VA Medical Center (CVAMC) voiced concerns that the process for Veterans with a cancer concern was fragmented, leading to potential delays in cancer diagnosis. The CVAMC developed an innovative process for the Cancer Fast Track Econsult (CFTE-C) to assist providers with expediting care for Veterans with a cancer concern. This process aims to improve communication between primary and specialty care providers, expedite pre-cancer workups, and allow more meaningful face to face first oncology specialty visits.

Methods: The E-consult is initiated by a primary care provider (PCP) in CPRS. After entering the CFTE-C an oncologist triages the consult to determine workup needed. The care coordinator (CC) ensures implementation of the plan of care and tracks its progression. This is done by the CC entering each Veteran into the Task Tracker (TT), a smart calendar that is used for communication and seamless coordination for selected Veterans. The CC continuously monitors the progression of diagnostic testing to ensure timeliness and identify delays. During the diagnostic process, the CC communicates the process to the PCP in CPRS. After cancer is confirmed or ruled out the CC discusses treatment plan with oncologist, documents in CPRS and notifies PCP.

Results: Since July 2015 there have been a total 145 veterans that have been referred to the CFTE-C. The average time from consultation to first action is 3 days. There is an average of about 6 CFTE-C consults monthly.

Implications: The CFTE-C process of using the TT allows the CC to monitor the Veterans workup and identify delays and barriers to care. The CC assists in eliminating any barriers or delays identified. The CFTE-C is underutilized by PCP’s and efforts are underway to improving utilization
by identifying a PCP champion in the outpatient clinics. There is also a need for clear measures of timeliness of care. Templated notes are in production to allow for clear tracking of the entire process including a clear handoff to PCP or referring provider.

Purpose: To improve access to specialty care for Veterans with a cancer concern and to improve communication among providers.

Background: Providers at the Cleveland VA Medical Center (CVAMC) voiced concerns that the process for Veterans with a cancer concern was fragmented, leading to potential delays in cancer diagnosis. The CVAMC developed an innovative process for the Cancer Fast Track Econsult (CFTE-C) to assist providers with expediting care for Veterans with a cancer concern. This process aims to improve communication between primary and specialty care providers, expedite pre-cancer workups, and allow more meaningful face to face first oncology specialty visits.

Methods: The E-consult is initiated by a primary care provider (PCP) in CPRS. After entering the CFTE-C an oncologist triages the consult to determine workup needed. The care coordinator (CC) ensures implementation of the plan of care and tracks its progression. This is done by the CC entering each Veteran into the Task Tracker (TT), a smart calendar that is used for communication and seamless coordination for selected Veterans. The CC continuously monitors the progression of diagnostic testing to ensure timeliness and identify delays. During the diagnostic process, the CC communicates the process to the PCP in CPRS. After cancer is confirmed or ruled out the CC discusses treatment plan with oncologist, documents in CPRS and notifies PCP.

Results: Since July 2015 there have been a total 145 veterans that have been referred to the CFTE-C. The average time from consultation to first action is 3 days. There is an average of about 6 CFTE-C consults monthly.

Implications: The CFTE-C process of using the TT allows the CC to monitor the Veterans workup and identify delays and barriers to care. The CC assists in eliminating any barriers or delays identified. The CFTE-C is underutilized by PCP’s and efforts are underway to improving utilization
by identifying a PCP champion in the outpatient clinics. There is also a need for clear measures of timeliness of care. Templated notes are in production to allow for clear tracking of the entire process including a clear handoff to PCP or referring provider.

Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).

Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.

Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).

Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.

Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.

Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).

Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.

Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).

Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.

Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.

Purpose: To address concerns of the cancer committee (CC) and facility regarding the transition use of the National Comprehensive Cancer Network (NCCN) Distress Thermometer (DT) to the Veteran Symptom Assessment Screen (VSAS).

Background: The Cleveland VA Medical Center (CVAMC) had used the NCCN DT since 2012. In March 2016, in conjunction with the Durham VAMC, the CVAMC began to pilot the VSAS screening tool to replace the NCCN DT. This initiative was an attempt to use one tool that could be used across all VAs to satisfy both The American College of Surgeon’s (ACOS) Commission of Cancer (CoC) accreditation as well as the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) Certification. The CVAMC locally added social elements of transportation, housing and insurance to the VSAS tool.

Methods: In March 2016 the Ear Nose and Throat (ENT) clinic continued to use the NCCN DT while the Oncology Clinics (OC) began to initiate the VSAS. In the CVAMC OC, Veterans that scored a 4 or greater on the VSAS tool in depression, anxiety, or distress or answered yes to transportation, housing, or insurance concerns had a Distress Screening Outpatient Consult entered into CPRS by the intake RN/LPN in clinic. The consultation was then signed off by the provider in clinic delivering care to Veteran that day. The consult was received, reviewed and completed by the oncology social worker (OSW) or the oncology behavioral health (OBH).

Results: In 2016 there were 162 NCCN DT distress screenings that were completed. 38% scored a 4 or above and required referral to OBH/OSW. Only 53% had complete documentation in CPRS. In contrast the VSAS in 2016 had 107 screenings that were completed. 31% required referral to OBH/OSW. 97% had complete documentation in CPRS.

Conclusions/Implications: This pilot project at the CVAMC allowed clear comparison between NCCN DT and VSAS tools. At our institution, the completion rate of the VSAS, referral and documentation process clearly was more effective than the NCCN DT process. Due to these outcomes the CC and facility made the decision to transition our distress screening process to the VSAS from the NCCN DT.