Mentor/Fellow Article

The Development of a Nursing Assessment and Symptom Management Clinic

Lynn Graze

Catherine Brady-Copertino

Ashley Varner

Wendy Stiver

cancer nursing, cancer nursing assessment, symptom management, symptom management clinic, outcome measures
CJON 2014, 18(5), 12-16. DOI: 10.1188/14.CJON.S2.12-16

The Anne Arundel Medical Center (AAMC) DeCesaris Cancer Institute (DCI) began its participation in the ONS Foundation-supported Breast Cancer Care Quality Measures Set pilot study in 2010. The design and measures of the project were intriguing, paving a path for DCI to define quality measures and outcomes that were of value to the AAMC's oncology population and system. As the pilot program was getting underway, measurement instruments were selected for fatigue, distress, and sleep-wake disturbances. These were used as quality measures for care of patients receiving chemotherapy, to be reported to the Oncology Quality Council, AAMC DCI's Executive Quality Council, and the AAMC Board of Directors. Scores for these quality measures, as well as patient satisfaction scores for the Outpatient Infusion Center, have increased markedly since the 2010 pilot test. The increases in scores inspired nursing leadership, in conjunction with AAMC DCI's Medical Oncology Executive Committee, to develop an innovative nursing model, the advanced oncology nurse practitioner-led symptom management clinic, to systematically and efficiently treat the needs of patients with cancer.

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    American College of Surgeons. (2012). Commission on Cancer: Ensuring patient-centered care. Cancer program standards 2012 [v.1.2.1]. Retrieved from
    American Society of Clinical Oncology. (2014). The state of cancer care in America, 2014: A report by the American Society of Clinical Oncology. Journal of Oncology Practice, 10, 119-142.
    Berry, D. (2011). Patient-reported symptoms and quality of life integrated into clinical cancer care. Seminars in Oncology Nursing, 27, 203-210.
    Berwick, D.M., & Hackbarth, A.D. (2012). Eliminating waste in US health care. JAMA, 307, 1513-1516. doi:10.1001/jama.2012.362
    Coolbrant, A. (2011). Immediate versus delayed self-reporting symptoms and side effects during chemotherapy: Does timing matter? European Journal of Oncology Nursing, 15, 130-136.
    Eaton, L.H., & Tipton, J.M. (Eds.). (2009). Putting Evidence Into Practice: Improving oncology patient outcomes. Pittsburgh, PA: Oncology Nursing Society.
    Fessele, K., Yendro, S., & Mallory, G. (2014). Setting the bar: Developing quality measures and education programs to define evidence-based, patient-centered, high-quality care. Clinical Journal of Oncology Nursing, 18(Suppl.), 7-11. doi:10.1188/14.CJON.S2.7-11
    Matsuda, A., Yamaoka, K., Tango, T., Matsuda, T., & Nishimoto, H. (2014). Effectiveness of psychoeducational support on quality of life in early-stage breast cancer patients: A systematic review and meta-analysis of randomized controlled trials. Quality of Life Research, 23, 21-30. doi:10.1007/s11136-013-0460-3
    Mayer, G.G., Villaire, M., & Connell, J. (2005). Ten recommendations for reducing unnecessary emergency department visits. Journal of Nursing Administration, 35, 428-430.
    Mori, M., Elsayem, A., Reddy, S., Bruera, E., & Fadul, N. (2012). Unrelieved pain and suffering in patients with advanced cancer. American Journal of Hospice and Palliative Care, 29, 236-240. doi:10.1177/1049909111415511
    Prybil, L.D., Bardach, D.R., & Fardo, D.W. (2014). Board oversight of patient care quality in large nonprofit health systems. American Journal of Medical Quality, 29, 39-43.
    Tipton, J. (2011, December). Principles of symptom assessment. Presented at the Oncology Quality Collaborative conference, Pittsburgh, PA.
    Vandyk, A.D., Harrison, M.B., McCarthey, G., Ross-White, A., & Stacey, D. (2012). Emergency department visits for symptoms experienced by oncology patients: A systematic review. Supportive Care in Cancer, 20, 1589-1599.