title: Florida Initiative for Quality Cancer Care: Changes in Psychosocial Quality of Care Indicators Over a 3-Year Interval.
abstract: Identifying and addressing psychosocial concerns is increasingly recognized as an important aspect of cancer care that needs to be improved. As part of the Florida Initiative for Quality Cancer Care, medical record reviews were conducted to evaluate cancer care, including psychosocial care, at oncology practices in Florida in 2006. Results were subsequently disseminated to the practices, and performance was reassessed at the same practices in 2009.
  
  
  
  Data were available for patients with colorectal, breast, and non-small-cell lung cancer first seen by a medical oncologist in 2006 (n = 1,609) and 2009 (n = 1,720) at the same 10 practice sites. Performance on each psychosocial indicator was evaluated for overall change over time and for variability in change based on practice site and cancer type.
  
  
  
  The percentage of patients identified as having a problem in emotional well-being increased significantly over time, from 24% to 31% among those assessed (P = .002) and from 13% to 16% overall (P = .026). In contrast, there no significant changes over time in assessment of emotional well-being (53% to 51%, P = .661) or in action taken to address problems (57% to 45%, P = .098).
  
  
  
  Findings suggest more intensive efforts than audit and feedback will be required to improve the quality of psychosocial care and that greater recognition of problems with emotional well-being may tax the ability of practices to link patients with appropriate services. Systematic research is needed to identify and disseminate effective strategies for implementing routine assessment of well-being and addressing the increased demands for care this will generate.
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL Paul.Jacobsen@moffitt.org.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Ji-Hyun
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: William
authors.initials: W
authors.lastname: Fulp
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: David
authors.initials: D
authors.lastname: Shibata
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Christine
authors.initials: C
authors.lastname: Laronga
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Jhanelle
authors.initials: J
authors.lastname: Gray
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Tawee
authors.initials: T
authors.lastname: Tanvetyanon
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Fred
authors.initials: F
authors.lastname: Schreiber
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Richard
authors.initials: R
authors.lastname: Brown
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Richard
authors.initials: R
authors.lastname: Levine
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cartwright
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Abesada-Terk
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: George
authors.initials: G
authors.lastname: Kim
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Carlos
authors.initials: C
authors.lastname: Alemany
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Douglas
authors.initials: D
authors.lastname: Faig
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Philip
authors.initials: P
authors.lastname: Sharp
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Merry-Jennifer
authors.initials: MJ
authors.lastname: Markham
authors.affiliation: Moffitt Cancer Center, Tampa; Center for Cancer Care & Research/Watson Clinic, Lakeland; Florida Cancer Specialists/Sarasota Memorial Hospital, Sarasota; Space Coast Medical Associates, Titusville; Florida Cancer Affiliates, Ocala; Robert & Carol Weissman Cancer Center at Martin Memorial, Stuart; Mayo Clinic, Jacksonville; Florida Hospital Cancer Institute, Orlando; North Broward Medical Center, Deerfield Beach; Tallahassee Memorial Healthcare, Tallahassee; and University of Florida/Shands Cancer Center, Gainesville, FL.
authors.forename: Mokenge
authors.initials: M
authors.lastname: Malafa
mesh_terms: D000368:Aged; 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; D008495:Medical Oncology / Q000592:standards; D008875:Middle Aged; D019984:Quality Indicators, Health Care / Q000592:standards*; D011787:Quality of Health Care / Q000458:organization & administration / Q000592:standards