title: Supporting commission on cancer-mandated psychosocial distress screening with implementation strategies.
abstract: OBJECTIVE
  The American College of Surgeons Commission on Cancer (CoC) has set psychosocial distress screening as a new patient care standard to be met by 2015. The standard requires CoC-accredited cancer centers to integrate and monitor distress screening and, when needed, refer patients to psychosocial health care services. We describe the uptake of distress screening reported by applicants to a distress screening cancer education program and the degree of and barriers to implementation of distress screening programs reported by selected participants.
  
  
  METHODS
  This cross-sectional study collected quantitative data online from applicants to the program between August 1 and November 15, 2013, described by frequencies, percentages, and measures of central tendency, and qualitative data in person from accepted participants on February 13, 2014, analyzed using an integrated approach to open-ended data.
  
  
  RESULTS
  Applications were received from 70 institutions, 29 of which had started distress screening. Seven of 18 selected applicant institutions had not begun screening patients for distress. Analysis of qualitative data showed that all participants needed to create buy-in among key cancer center staff, including oncologists; to decide how to conduct screening in their institution in a way that complied with the standard; and to pilot test screening before large-scale rollout.
  
  
  CONCLUSIONS
  Fourteen months before the compliance deadline, fewer than half of applicant institutions had begun distress screening. Adding implementation strategies to mandated quality care standards may reduce uncertainty about how to comply. Support from key staff members such as oncologists may increase uptake of distress screening.
authors.affiliation: Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL mark.lazenby@yale.edu.
authors.forename: Mark
authors.initials: M
authors.lastname: Lazenby
authors.affiliation: Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ercolano
authors.affiliation: Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL.
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.affiliation: Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL.
authors.forename: Jimmie C
authors.initials: JC
authors.lastname: Holland
authors.affiliation: Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Jacobsen
authors.affiliation: Yale University School of Nursing, New Haven, CT; City of Hope, Duarte, CA; Memorial Sloan Kettering Cancer Center, New York, NY; and Moffitt Cancer Center, Tampa, FL.
authors.forename: Ruth
authors.initials: R
authors.lastname: McCorkle
mesh_terms: D002173:Cancer Care Facilities / Q000592:standards; D003430:Cross-Sectional Studies; D004502:Education, Medical, Continuing; D006284:Health Plan Implementation / Q000379:methods* / Q000592:standards; D006801:Humans; D007318:Inservice Training; D008403:Mass Screening / Q000379:methods* / Q000592:standards; D008495:Medical Oncology / Q000379:methods* / Q000592:standards; D009369:Neoplasms / Q000150:complications / Q000175:diagnosis / Q000523:psychology* / Q000628:therapy; D011237:Predictive Value of Tests; D016730:Program Development; D015397:Program Evaluation; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012017:Referral and Consultation; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D014481:United States