title: Examining the introduction of a supportive care screening and referral process for cancer patients: how does practice compare with protocols?
abstract: OBJECTIVE
  The aim of this study was to examine the introduction of a supportive care screening and referral process into clinical practice for patients with cancer, and to determine how clinicians' actions compared to evidence-based protocols contained within the Supportive Care Resource Kit.
  
  
  METHODS
  A Supportive Care Resource Kit was developed as a resource for clinicians to enable a systematic process of screening cancer patients for unmet supportive care needs and addressing these needs by using evidence-based protocols. Clinicians were recruited and trained in supportive care and the use of the kit. Patients were recruited and screened for their supportive care needs. Patients and clinicians undertook a problem solving discussion, which was documented and analysed using content analysis.
  
  
  RESULTS
  In applying the screening process, clinicians undertook discussion, referral and information provision with patients. Comparison to evidence-based protocols revealed that practice was predominantly in line with protocols. Overall, clinicians' practice matched well with guidance from the protocols on discussion and referral, but less so in providing information to patients. Actions taken between supportive care domains differed with clinician preference evident for dealing with physical problems compared with practical, emotional and family problems.
  
  
  CONCLUSIONS
  Implications for practice and research include, exploring strategies for broadening clinician confidence in dealing with all areas of supportive care needs; undertaking further research into the use of protocols in health care and incorporating strategic, multidisciplinary planning in protocol implementation schemes.
authors.affiliation: Department of Rural and Indigenous Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, P.O. Box 973, Moe, 3825, Victoria, Australia. melanie.regan@monash.edu
authors.forename: Melanie
authors.initials: M
authors.lastname: Regan
authors.forename: Eli
authors.initials: E
authors.lastname: Ristevski
authors.forename: Rebecca
authors.initials: R
authors.lastname: Jones
authors.forename: Sibilah
authors.initials: S
authors.lastname: Breen
authors.forename: Allison
authors.initials: A
authors.lastname: Hartney
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002985:Clinical Protocols; D019317:Evidence-Based Medicine; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009369:Neoplasms / Q000523:psychology*; D010353:Patient Education as Topic / Q000592:standards; D012017:Referral and Consultation / Q000458:organization & administration*; D055815:Young Adult