Guiding lay navigation using the distress thermometer.

Academic Article

Abstract

  • 195 Background: The Commission on Cancer will require distress evaluation in 2015, given growing emphasis on psychosocial care. We report on a novel use of the distress thermometers (DTs) to frame navigator-patient interactions. METHODS: Thirty-eight lay (non-clinical) navigators were trained to utilize a comprehensive distress thermometer to evaluate patients in the Patient Care Connect program (PCCP). The PCCP is a 12-center network throughout AL, MS, GA, FL and TN that serves Medicare patients ≥ 65 with cancer. During patient interactions, navigators assess causes of distress and requests for intervention (barrier). Scores ≥ 4/10 trigger intervention. Navigators report symptom-related barriers to providers for proactive management and address non-clinical barriers by empowering patients to connect to available resources. RESULTS: Of the first 3,000 patients with DTs, pain (n=367), fatigue (n=304), and mobility issues (n=217) were the most common sources of distress. Although pain was common, only 32% requested intervention. Intervention was most often requested for distress related to knowledge deficits about treatment (75%), transportation (69%), and insurance/financial (67%). Patients requested intervention in 32.8% of assessments. Over 90% of all barriers were resolved. CONCLUSIONS: The PCCP uses the DT as an integral navigation screening across multiple health systems of varying size and structure. This approach provides continuity and structure to extend the workforce using lay navigators. Use of the DT allows for identification of quality of life, informational, and logistical barriers to care. Monitoring patients using navigator administered DTs is a promising tool for future application across multiple health systems. Additionally, data collected by the DT can be used to identify themes in distress for further research and to design comprehensive interventional programs. The project described was supported by Grant Number 1C1CMS331023 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this abstract are solely the responsibility of the authors and do not necessarily represent the official views of the U.S. Department of Health and Human Services or any of its agencies.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Taylor RA; Kvale EA; Acemgil A; Demark-Wahnefried W; Meneses K; Martin M; Lisovicz N; Pisu M; Fouad M; Partridge EE
  • Start Page

  • 195
  • Volume

  • 32
  • Issue

  • 31_suppl