The Rossy Cancer Network (RCN) and Cancer Care Ontario (CCO) have received just over $1-million in funding from the Canadian Partnership Against Cancer for the Improving Patient Experience and Health Outcomes Collaborative (iPEHOC). This three-year project will facilitate the uptake of a standardized core set of patient-reported outcome measures (PROMs) and patient-reported experience measures (PREMs), and their meaningful use in clinical practice to reduce symptom burden and improve the patient experience of cancer and care. The goal is to develop a common and sustainable patient experience measurement system that can be used across Canada.
After initial screening for distress on a series of symptoms, iPEHOC will target and implement specialized assessments of patients’ levels of anxiety, depression, pain and fatigue, so those who need help can be quickly and efficiently referred for appropriate psychosocial care services support. The project will evaluate whether implementation of the patient experience measurement system and referral ultimately leads to timely and targeted reductions in symptoms, and impacts the overall patient experience, in addition to evaluating patient satisfaction with health care delivery and health care utilization.
“The partnership is proud to partner with the RCN and CCO on this joint collaboration to improve the journey of cancer patients,” explains Dr. Heather Bryant, VP of Cancer Control at CPAC. “Our goal is to work with partners across Canada to find ways to improve the experience of patients as they go through their journey in the cancer control system. We believe this initiative will be instrumental in developing common tools to measure the distress and symptoms of patients that will help to provide them with the necessary support and ultimately improve health outcomes.”
Multi-hospital partnership
iPEHOC is a partnership that includes CCO’s Northeast Cancer Centre, Trillium Health Partners, Princess Margaret Cancer Centre and the RCN’s McGill University Health Centre (MUHC), Jewish General Hospital (JGH), St. Mary’s Hospital Center (SMHC) and their respective Aboriginal Cancer Control Units (this may include the First Nations, Inuit and Metis communities).
The project was officially launched in Montreal on March 27 and 28, when 40 physicians, nurses, psychologists, IT specialists, project managers and patient representatives from the participating hospitals gathered for a two-day planning session. The goal of this kick-off meeting was to convene the various venue participants, to discuss the overall structure of the project and the partnership and to define the implementation targets for each of the three-years of the project.
“This is an exciting, but massive project,” says Dr. Zeev Rosberger, iPEHOC co-lead and Director of the Louise Granofsky-Psychosocial Oncology Program at the JGH. “This multi-hospital, multi-province project will help create greater collaboration amongst the oncology teams at the RCN and CCO, providing opportunities to share expertise, resources and knowledge. Ultimately, it will also serve to improve and standardize the psychosocial screening and care patients can expect to receive across Canada.”
35% to 40% of patients experience significant distress
Cancer is a difficult disease with which to cope. No two people will respond in the same way. But all cancer patients experience some level of distress associated with the disease and the stages of treatment.
“Research has shown distress is common in persons living with cancer. Specifically, 35-40% of persons with cancer experience sufficient distress (such as feelings of sadness and anxiety) that they require specialized services,” says Dr. Marc Hamel, site lead for iPEHOC and Clinical Director of the Psychosocial Oncology Program at the MUHC. “Furthermore, more and more research indicates psychosocial interventions can help reduce distress. Untreated emotional distress can leave the patient suffering, impacts his/her quality of life and can impact his/her adherence to treatment.”
Monitoring and identifying patients in distress helps to improve patient-health care provider relationships, identifies the key needs of the patient and helps the health care professional get a quick snapshot view of the whole-person care above and beyond the physical disease.
According to Rosanna Faria, site lead and Coordinator of the Psychosocial Clinic at St. Mary’s Hospital Center, the iPEHOC initiative complements the RNC’s mission to improve the quality of cancer care and enhance patient satisfaction. Distress screening gets patients engaged in identifying the sources of their distress, motivates participation in the referral process and enhances adherence to treatment plans. The health care provider-patient partnership facilitates a comprehensive plan integrating medical treatment and psychosocial and supportive care into a true ‘whole person care” approach.