Initial evaluation of quality indicators for psychosocial care of adults with cancer

The American Psychosocial Oncology Society has developed the first indicators of the quality of psychosocial care for cancer patients. This report describes the initial evaluation of these indicators. Medical records of 388 colorectal cancer patients first seen by a medical oncologist in 2006 at seven practice sites were reviewed by trained abstractors whose accuracy was documented by periodic checks. Rates of assessment of emotional well-being within 1 month of a patient's first visit with a medical oncologist ranged from 6% to 84% (mean = 60%; P < .001). Among the 45 patients identified as having a problem with emotional well-being, rates of evidence of action taken (or explanation for no action) ranged from 0% to 100% (mean = 51%; P = .85). A direct comparison showed that pain was assessed more often than emotional well-being in these patients (87% vs 60%, P < .001). Findings show these indicators can be measured easily and reliably, demonstrate variability across practices that suggests potential for improvement, and yield information that can be used to take actions to improve quality. Additional findings suggest that, to date, efforts to promote routine symptom assessment have been more successful for pain than for emotional well-being.