title: Psychosocial distress screening implementation in cancer care: an analysis of adherence, responsiveness, and acceptability.
abstract: OBJECTIVE
  The American College of Surgeons Commission on Cancer has mandated implementation of a systematic protocol for psychosocial distress screening and referral as a condition for cancer center accreditation beginning in 2015. Compliance with standards requires evidence that distress screening protocols are carried out as intended and result in appropriate referral and follow-up when indicated. The purpose of this study was to examine the fidelity of distress screening protocols at two tertiary cancer treatment centers.
  
  
  METHODS
  A retrospective review and analysis of electronic medical records over a 12-week period examined clinic adherence to a prescribed distress screening protocol and responsiveness to patients whose scores on the National Comprehensive Cancer Network Distress Thermometer (DT) indicated clinically significant levels of distress requiring subsequent psychosocial contact. A weekly online survey assessed clinician perspectives on the acceptability of the protocol.
  
  
  RESULTS
  Across clinics, rates of adherence to the distress screening protocol ranged from 47% to 73% of eligible patients. For patients indicating clinically significant distress (DT score ≥ 4), documentation of psychosocial contact or referral occurred, on average, 50% to 63% of the time, and was more likely to occur at one of two participating institutions when DT scores were high (DT score of 8 to 10). Clinician assessments of the protocol's utility in addressing patient concerns and responding to patient needs were generally positive.
  
  
  CONCLUSIONS
  Systematic tracking of distress screening protocols is needed to demonstrate compliance with new standards of care and to demonstrate how well institutions are responding to their clinical obligation to address cancer patients' emotional and psychosocial needs.
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY. zebrack@umich.edu.
authors.forename: Brad
authors.initials: B
authors.lastname: Zebrack
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Karen
authors.initials: K
authors.lastname: Kayser
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Laura
authors.initials: L
authors.lastname: Sundstrom
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Sue Ann
authors.initials: SA
authors.lastname: Savas
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Chris
authors.initials: C
authors.lastname: Henrickson
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Chiara
authors.initials: C
authors.lastname: Acquati
authors.affiliation: Brad Zebrack, Laura Sundstrom, and Sue Ann Savas, University of Michigan School of Social Work; Chris Henrickson, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; Brad Zebrack, Association of Oncology Social Work, Deerfield, IL; Karen Kayser and Chiara Acquati, University of Louisville Kent School of Social Work; Rebecca L. Tamas, James Graham Brown Cancer Center; and Rebecca L. Tamas, University of Louisville School of Medicine, Louisville, KY.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Tamas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D011602:Psychophysiologic Disorders / Q000150:complications / Q000175:diagnosis*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult