Date of Graduation

Winter 12-18-2015

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions



First Advisor

Marjorie Barter, DNP

Second Advisor

Timothy Godfrey, SJ, DNP

Third Advisor

Kavitha Ramchandran, MD


Background: People experiencing serious illness have significant unmet physical, emotional, social and spiritual needs. The Quality Oncology Practice Initiative (QOPI) requires patients to be screened for emotional wellbeing and pain by their second oncology visit. This project details one cancer center’s quality improvement initiative to (a) implement electronic screening of every cancer patient by their second oncology visit, (b) design processes for ongoing assessment and intervention of need(s), and (c) develop measurable and sustainable evaluation metrics to ensure that palliative care needs are met. Methods: In June 2015, we launched electronic collection of patient-reported outcomes (PROs) using the Patient Reported Outcome Measurement Instrument System (PROMIS) global screen. Screening was completed via the health portal or clinic computer prior to the first return visit and at 30-day intervals. Results: The primary measures of interest were the percentage of completed PROMIS questionnaires and the percentage of relevant answers, with a target completion rate of 60%. The highest completion rate was 25.3%. Six weeks of relevant answers were collated from August 18, 2015 through September 30, 2015 with a range of 3.6% to 5.3% of patients having relevant answers. Conclusions: The utilization of a screening tool is only the method by which assessment and evaluation of comprehensive care needs is initiated. Evidence-based practice guidelines and clinical care pathways must also be in place to manage each symptom identified in a standardized way. Support for oncology nurses to lead assessment and connect patients with resources is an opportunity to incorporate primary palliative care into oncology practice.

DNPProjectPresentation_12-4-2015.pdf (11081 kB)
DNP Powerpoint Presentation