Project Information

UF Health Cancer Center Distress Screening Program Development, Implementation, and Analyses

Project Description: In 2012, the American College of Surgeons (ACoS) Commission on Cancer (CoC) published Cancer Program Standards that required hospital cancer committees to develop and implement a process to integrate and monitor on-site psychosocial distress screening and referral for treatment as standard of care. Basic requirements for this process included: (1) distress must be assessed at least once during a pivotal medical visit, (2) a strong preference for standardized and validated measures with clinical cut-offs, (3) individuals with moderate/severe distress must be referred to appropriate resources for management, (4) assessment, referral, and follow-up must be documented in the medical record, and (5) the policies and procedures must be overseen by the hospital cancer committee’s psychosocial representative. For the University of Florida Health Cancer Center (UFHCC) Dr. Deidre Pereira, Associate Professor in the Department of Clinical and Health Psychology was appointed to oversee this process with Dr. Merry-Jennifer Markham, Associate Professor in the Department of Hematology/Oncology. In 2014, distress screening policies and procedures were developed by Drs. Pereira and Markham. Specifically, it was determined that patients attending visits in Medical Oncology would undergo screening via administration of the Distress Thermometer, problem-area checklist, and Patient Health Questionnaire – 2 by medical assistants at the point of assessment of vitals. Individuals scoring > 7 on the Distress Thermometer and/or > 3 on the PHQ-2 were deemed to have a positive distress screening, requiring a referral to Oncology Social Work with or without other appropriate referrals (e.g., Psycho-Oncology Service in the Psychology Clinic). These procedures were piloted started in October 2015 and then formally and routinely implemented in January 2016. In approximately November 2016, these procedures were also implemented in Radiation Oncology. Drs. Pereira and Markham lead a Distress Screening Clinical Quality Improvement Team comprised of the following individuals: Jennifer Adams, LCSW, Oncology Social Work Brigette Coleman, MSW, Oncology Social Work Debra Hutchinson, RN, BSN, OCN Victoria Pearson, LCSW, Oncology Social Work Michele Scavone-Stone, M.ED, Oncology

QPI: Deidre, Pereira, (



UF Health Big Aims: Enhance the Patient Experience None

MeSH Keywords: Cancer, Supportive Care, Psycho-Oncology, Distress Screening, Quality Improvement