title: Evaluating the quality of psychosocial care in outpatient medical oncology settings using performance indicators.
abstract: OBJECTIVE
  An American Psychosocial Oncology Society workgroup has developed indicators of the quality of psychosocial care that can be measured through review of medical records. The present report describes the first large-scale use of these indicators to evaluate psychosocial care in outpatient medical oncology settings.
  
  
  METHODS
  Medical records of 1660 colorectal, breast and non-small cell cancer patients first seen by a medical oncologist in 2006 at 11 practice sites in Florida were reviewed for performance on indicators of the quality of psychosocial care.
  
  
  RESULTS
  Assessment of emotional well-being was significantly less likely to be documented than assessment of pain (52 vs 87%, p<0.001). A problem with emotional well-being was documented in 13% of records and evidence of action taken was documented in 58% of these records. Ten of eleven practice sites performed below an 85% threshold on each indicator of psychosocial care. Variability in assessment of emotional-well being was associated (p<0.02) with practice site and patient gender and age while variability in assessment of pain was associated (p<0.001) with practice site and cancer type.
  
  
  CONCLUSIONS
  Findings illustrate how use of the psychosocial care indicators permits identification of specific practice sites and processes of care that should be targeted for quality improvement efforts. Additionally, findings demonstrate the extent to which routine assessment of emotional well-being lags behind routine assessment of pain in cancer patients.
authors.affiliation: Moffitt Cancer Center, Tampa, FL 33612, USA. paul.jacobsen@moffitt.org
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.forename: David
authors.initials: D
authors.lastname: Shibata
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: William J
authors.initials: WJ
authors.lastname: Fulp
authors.forename: Carlos
authors.initials: C
authors.lastname: Alemany
authors.forename: Guillermo
authors.initials: G
authors.lastname: Abesada-Terk
authors.forename: Richard
authors.initials: R
authors.lastname: Brown
authors.forename: Thomas
authors.initials: T
authors.lastname: Cartwright
authors.forename: Douglas
authors.initials: D
authors.lastname: Faig
authors.forename: George
authors.initials: G
authors.lastname: Kim
authors.forename: Richard
authors.initials: R
authors.lastname: Levine
authors.forename: Merry-Jennifer
authors.initials: MJ
authors.lastname: Markham
authors.forename: Fred
authors.initials: F
authors.lastname: Schreiber
authors.forename: Philip
authors.initials: P
authors.lastname: Sharp
authors.forename: Mokenge
authors.initials: M
authors.lastname: Malafa
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000628:therapy; D002289:Carcinoma, Non-Small-Cell Lung / Q000523:psychology / Q000628:therapy; D015179:Colorectal Neoplasms / Q000523:psychology / Q000628:therapy; D005260:Female; D005431:Florida; D006801:Humans; D008175:Lung Neoplasms / Q000523:psychology / Q000628:therapy; D008297:Male; D008485:Medical Audit; D008495:Medical Oncology / Q000592:standards*; D008605:Mental Health Services / Q000592:standards*; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology / Q000628:therapy*; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000592:standards; D019984:Quality Indicators, Health Care / Q000592:standards; D055815:Young Adult