Evaluating the quality of psychosocial care in outpatient medical oncology settings using performance indicators.
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.
Jacobsen
Paul B
PB
Moffitt Cancer Center, Tampa, FL 33612, USA. paul.jacobsen@moffitt.org
Shibata
David
D
Siegel
Erin M
EM
Lee
Ji-Hyun
JH
Fulp
William J
WJ
Alemany
Carlos
C
Abesada-Terk
Guillermo
G
Brown
Richard
R
Cartwright
Thomas
T
Faig
Douglas
D
Kim
George
G
Levine
Richard
R
Markham
Merry-Jennifer
MJ
Schreiber
Fred
F
Sharp
Philip
P
Malafa
Mokenge
M
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