226 Background: Psychosocial distress can impact a patient’s quality of life and potentially impact timely and effective cancer management. The National Comprehensive Cancer Network (NCCN) developed a distress thermometer that includes a ten point scale of distress and checklist of psychosocial issues. In this analysis we compare rates of referrals to our support services prior to and post implementation of this tool in our community oncology practice. Methods: Data one year prior to and post implementation of the NCCN distress thermometer was retrospectively reviewed. The tool was implemented in July 2013 and administered to the patients by our clinical staff at the patient’s first visit. Based on this tool, the clinical staff offered referrals to social work, chaplaincy, nutrition, or financial counseling. Re-education on administration of this tool occurred in January 2014. In this study we compare support service referrals pre and post NCCN distress screening implementation and staff education. Results: From July 2012 to June 2013, 829 referrals were made to support services. Specifically, 39% of these referrals were to social work, 19% to chaplaincy, and 38% to nutrition. From July 2013 to May 2014, 1434 referrals were made to support services. Specifically, 37% of these referrals were to social work, 10% to chaplaincy, 20% to nutrition, and 34% to financial counseling. Referrals to social work were most impacted by implementation of the NCCN distress screening with a median increase from 26.5 (range 14-45) to 45 (range 32-68). Referrals to other support services were not impacted. Referrals to financial counseling were most impacted by the re-education process with a median increase from 38 (range 28-42) to 53 (range 42-58). Conclusions: Implementation of the NCCN distress thermometer allowed better identification of patients for social work and financial counseling interventions. This tool was less effective at increasing referrals to nutrition and chaplaincy. The need for these services may be better captured during the treatment period. Future investigation into this may include application of the distress tool during subsequent patient visits.
