146 Background: In 2013, the Institute of Medicine report recommended that supportive oncology services be initiated at time of diagnosis. Providers of pediatric cancer care in the Chicagoland community, supported by The Coleman Foundation, sought to define areas for quality improvement of supportive oncology delivery to children. Methods: Focus groups and surveys with clinicians providing pediatric cancer care and supportive services at 14 sites were used to prioritize areas needing improvement. Results: 100% (14/14) of sites participated. Of the eligible sites, 6 were pediatric cancer treatment sites and 8 cancer care community organizations. Sites demonstrated consistent agreement for 8 of the 12 areas of focus for improvement. Over 50% of sites reported areas of focus (table) as important or very important. Conclusions: Sites identified the need for quality improvement in delivery of psychosocial, survivorship and palliative care for pediatric cancer patients. Survey results demonstrate a need for collaboration and efforts to guide care delivery improvement across sites. [Table: see text]
163 Background: In 2012, a congressional symposium identified the need for services to address psychosocial issues of children with cancer. In 2013, the Institute of Medicine recommended supportive oncology services be initiated at cancer diagnosis. Chicago providers of pediatric cancer are collaborating to improve care for children with cancer and their families focusing on psychosocial stressors and quality of life. Methods: The collaborative conducted a structured review of tools: Psychosocial Assessment Tool (PAT), Social Work Assessment Tool (SWAT), National Comprehensive Cancer Network (NCCN) Problem List, and √IN; with input from providers on stressors throughout the care continuum. The resulting screening tool was created and piloted in English and Spanish at 7 pediatric cancer hospitals. Social workers (SW) informally reported assessment of its usefulness. Results: Parents (n = 85) completed “Getting to Know You and Your Child” screening tool which inquired about caregivers, siblings, child’s interests, school, SSI/SNAP, challenges, and cultural/religious preferences. Providers reported families found the tool useful “to think about support needs.” The tool assessed 12 psychosocial stressors; the mean per patient/family was 2.4 (range 0-11). Most frequent stressors included: lack of support from friends, family, community (29%), paying for food (26%), job flexibility (26%), paying for utilities (25%), medical costs (23%), emotional support for family (22%), school concerns (21%). All who reported temporary residence also reported difficulty paying for housing (p < 0.01). Ten SWs reported this screening tool generated new insight into family structures, identified stressors and informed resolution efforts. Provider recommended adjustments to the screening tool: simplify terms for siblings, hobbies and spiritual, add pet question. Conclusions: Pilot testing of a psychosocial screening tool for pediatric and adolescent oncology informed providers of patient/family needs in a standard manner. Six of the seven pilot sites are implementing this tool as a standard practice. Preliminary data suggests patients and providers find the screener easy to use and informative.
150 Background: In 2013 the Institute of Medicine recommended that supportive oncology services be initiated at time of cancer diagnosis. Providers of pediatric cancer care in the Chicago metro area, supported by The Coleman Foundation, created and pilot tested a standard psycho-social stressors screening instrument for children with cancer and their families. Methods: The collaborative conducted structured review of tools: Psychosocial Assessment Tool (PAT), Social Work Assessment Tool (SWAT), National Comprehensive Cancer Network (NCCN) Problem List, and √IN; and collected input from social workers and oncology providers on stressors throughout the care continuum. The resulting tool was piloted in English and Spanish at 7 pediatric cancer hospitals. Providers qualitatively reported assessment of its usefulness. Results: Patients/family (n = 57) completed the “getting to know you and your child” instrument which inquired about caregivers, siblings, child’s likes/hobbies, school situation, SSI/SNAP, challenges, and cultural/religious preferences. Providers reported that almost all families found the tool useful “to think about support needs”; one said it was invasive. The tool assessed 12 psychosocial stressors; the mean per patient/family was 2.49 (range 0-11). The most frequent stressors were support from friends, family, community (30%), paying for food (26%), job flexibility (26%), school concerns (25%), emotional support for family (25%), and medical costs (23%). All who reported temporary housing also reported difficulty paying for a place to live (p < 0.0001). Providers reported that the standard tool generated new insight into family structures, challenges and needs informing resolution efforts. Provider recommended adjustments: simplify terms for siblings, hobbies and spiritual, adding question about pets in the home. Conclusions: Pilot testing of a psycho-social screening tool for pediatric and adolescent oncology informed providers of patient/family needs in a standard manner. Four of the seven sites involved in the pilot are now implementing this tool as a standard practice; the remaining sites are performing analyses on how to incorporate the tool into their care processes.
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