Increasing the Evidence Base for Psychosocial Care
By studying and learning about implementation of the Standards
PRACTICE & RESEARCH
MD Anderson Implementing the Psychosocial Standards
Mattie Miracle is grateful to the Psychosocial Team at MD Anderson Cancer Center's Children's Cancer Hospital. Their commitment to applying and implementing the Psychosocial Standards of Care into practice illustrates the importance of the Standards at improving health outcomes and quality of life for patients, families, clinicians, and institutions. Mattie Miracle specifically thanks Rhonda Robert, PhD, ABPP, Daniel Smith, M.Ed., and Pete Stavinoha, PhD, ABPP for being Psychosocial Standards of Care champions at MD Anderson.
Here is the Psychosocial Team Leaders' insights and reflections on how the Standards have impacted their work:
While the University of Texas MD Anderson Cancer Center’s Children’s Cancer Hospital has a rich history of psychosocial service delivery, including a number of dedicated pediatric psychosocial service lines including School Services, Arts in Medicine, Music Therapy, Psychology and Neuropsychology, Social Work, Child Life, and Chaplaincy, we recognized that many services were somewhat unaware of the others and that improved awareness and coordination of care would certainly improve the range and coverage of psychosocial services available to patients and their families.
In 2017, a multidisciplinary Psychosocial Team was formed within the Division of Pediatrics. Team members self-selected and represented a range of psychosocial service providers and interested stakeholders. Our Psychosocial Team needed direction for how to proceed most effectively in reviewing, improving, and in some cases adding to the range of services provided. The Psychosocial Standards of Care for Pediatric Oncology provided the ideal framework for reviewing the portfolio of psychosocial services available within the MD Anderson Children’s Cancer Hospital.
Members of the Psychosocial Team became familiar with each of the Psychosocial Standards, and in the following year we met regularly to review and match existing services according to what is called for in the Psychosocial Standards. This resulted in self-congratulations where MD Anderson was doing well, and the process simultaneously identified areas where there was clearly room for improvement. Among the benefits of this process was the dissemination and communication of the various services, events, and opportunities already provided to patients and families – this was enlightening and informative for team members and stakeholders and a summary of the review formed the basis of dissemination of available psychosocial services and supports to all the clinical teams.
Another result of our review was to recognize how inconsistently psychosocial services were utilized by the medical teams. This led directly to each discipline developing “referral guidelines” and more standardized referral methodologies (e.g., improved utilization of electronic medical record compared to email or informal consultation) with clear triggers for referral of patients and families for psychosocial services.
Where clear gaps were identified in how we were meeting the Psychosocial Standards, task forces were engaged to dig deeper and see where improvements can be made. These included a Sibling Task Force and a Financial Distress Task force, both of whom continue to work and develop strategies to improve these dimensions of psychosocial care.
Finally, our Psychosocial Team review of the Psychosocial Standards resulted in team members noting omission of spiritual care among the services covered in the standards. Along with external collaborators, we conducted and published a systematic review of spiritual care in pediatric oncology and recommended consideration of an additional Psychosocial Standard of Care.
Our next phase of Psychosocial Team activity involves systematic assessment of the MD Anderson Children’s Cancer Hospital’s psychosocial offerings, and the Matrix and Guidelines provide the perfect toolkit for identifying how we are doing, barriers to implementation, and a pathway toward optimal psychosocial care for the patients and families we serve.
We invite you to read the article written by the MD Anderson Children's Cancer Hospital's psychosocial team leaders on the proposed 16th Psychosocial Standard of Care.
Robert, R., Stavinoha, P., Jones, B. L., Robinson, J., Larson, K., Hicklen, R., ... & Weaver, M. S. (2019). Spiritual assessment and spiritual care offerings as a standard of care in pediatric oncology: A recommendation informed by a systematic review of the literature. Pediatric Blood & Cancer, 66(9), e27764.