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Feasibility of a quality improvement strategy integrating psychosocial care into 28 medical cancer centers (HuCare project)

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Abstract

Purpose

This study examines the development and feasibility of a quality improvement strategy for the translation of evidence-based psychosocial care into clinical practice.

Methods

The project involved all staff (oncologists, psychologists, and nurses) of the participating centers. Recommendations concerned: improvement of clinician communication skills; use of a patient question prompt list; assignment of a specialist nurse to each patient; screening for psychological distress and social needs; opportunity to attend a Point of Information and Support. The implementation strategy hinged on context analysis and problem solving. Four to six visits were held in each center by the project team to assist staff in identifying obstacles, finding solutions, and strengthening motivation. The primary variable was the adherence percentage to the recommendations (proportion of subjects receiving each intervention). The number of centers that failed to reach the objective was also reported (adherence percentage <75 %).

Results

Twenty-seven of twenty-eight centers completed the study. Lack of resources was the most commonly perceived barrier preimplementation. Five-hundred-forty-five clinicians were actively involved in the project and completed training. The adherence percentage for each recommendation was greater than 85 % except for the question prompt list (78 %; 95 % CI, 73–83 %), where seven centers did not reach the objective.

Conclusions

Our findings demonstrate that evidence-based interventions to improve the psychosocial care of people with cancer can be implemented in a diverse range of oncology wards. This requires the involvement and motivation of the entire staff of the ward, support by an expert team, and promotion by policymakers.

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Acknowledgments

We are grateful to Lesley Fallowfield for contributing her invaluable experience in the planning of the training. Our thanks go to Silvia Filiberti and Maria Grazia Ollari for conducting context analysis and to Gianvito Donati, Raffaele Maddalena and Pietrantonio Zerla for contributing to the drafting of the manuals and for conducting on-site problem-solving visits. We finally thank Elisa Iezzi for her support with data processing and database management.

Conflict of interest

The authors state that they have no financial relationship with the organization that sponsored the research, that they have full control of all primary data, and that they agree to allow the journal to review their data if requested.

Author information

Authors and Affiliations

  1. Division of Medical Oncology, Istituti Ospitalieri di Cremona, Viale Concordia, 1, Cremona, 26100, Italy

    Rodolfo Passalacqua & Jessica Saleri

  2. Unit of Oncological Psychology, Centro di Riferimento Oncologico National Cancer Institute, Aviano, Italy

    Maria Antonietta Annunziata

  3. Unit of Clinical Psychology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Claudia Borreani

  4. Research and Innovation Unit, University Hospital of Parma, Parma, Italy

    Francesca Diodati & Caterina Caminiti

  5. Division of Oncology, Hospital of Melegnano, Milan, Italy

    Luciano Isa

  6. Division of Medical Oncology, Hospital of Saronno, Saronno, Varese, Italy

    Claudio Verusio

Authors
  1. Rodolfo Passalacqua
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  2. Maria Antonietta Annunziata
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  4. Francesca Diodati
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  8. Caterina Caminiti
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Correspondence to Rodolfo Passalacqua.

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Passalacqua, R., Annunziata, M.A., Borreani, C. et al. Feasibility of a quality improvement strategy integrating psychosocial care into 28 medical cancer centers (HuCare project). Support Care Cancer 24, 147–155 (2016). https://doi.org/10.1007/s00520-015-2756-z

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  • DOI: https://doi.org/10.1007/s00520-015-2756-z

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