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DART at Princess Margaret

Princess Margaret is currently ranked 1st in the province
for the number of unique patients screened per month.

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DISTRESS ASSESSMENT & RESPONSE TOOL

DART is a web-based, touch-screen, Distress Assessment and Response Tool
to enhance the detection of physical and emotional distress in cancer patients.

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Benefits of using DART

Scalable

Customizable

Compatible with Oracle / MySQL

Uses Multiple Validated Scales

Multi-User Accounts

Intelligent Programming

Why screen for distress?

A system based only on physician or patient-initiated referrals to psychological services might fail to identify or overlook a significant portion of emotionally distressed patients in need. Systemic screening promotes equal access to these services.

What is DART?

DART is a tool that can enhance the detection of physical and emotional distress in cancer patients. DART employs standardized and validated measures of physical distress, anxiety, depression and social difficulties to draw attention to areas of difficulty or distress for patients. The electronic component of DART is a web-based, touch-screen, tool that gathers patient input in a user-friendly way and provides easy-to-read print-outs for the patients and for the oncology team.

Impact at Princess Margaret

There is evidence of increased staff engagement, patient and clinician satisfaction, and documentation of clinical interventions.

This focused, targeted approach will result in optimal use of resources while providing personalized cancer medicine within Princess Margaret.

DART AT PRINCESS MARGARET

Princess Margaret is currently ranked 1st in the province for the number of unique patients screened per month

Why Screen for Distress?

A system based only on physician or patient-initiated referrals to psychological services might fail to identify or overlook a significant portion of emotionally distressed patients in need. Systemic screening promotes equal access to these services. The National Comprehensive Cancer Network (NCCN) has developed standards of care for distress which state that, “All patients should be Screened for Distress at their initial visit, and at appropriate intervals, as clinically indicated.”

What is Distress?

Distress is a multifactorial unpleasant emotional experience of a psychological (cognitive, behavioural, emotional), social, and / or spiritual nature that may interfere with the ability to copy effectively with cancer, its physical symptoms and its treatment. Distress extends along a continuum, ranging from common normal feelings of vulnerability, sadness, and fears to problems that can become disabling, such as depression, anxiety, panic, social isolation, and existential and spiritual crisis.

  • What is DART?

    The tool is linked to an inter-professional distress response care path, graded to the individual patient’s level of distress. DART is a patient centered initiative that not only focuses on screening for distress in the physical, psychosocial and practical domains of health, but also has a clearly defined response algorithm built in based on an inter-professional collaborative care approach. DART is novel as it not only combines innovation with patient centered care but it sets out a framework for triaged collaborative care and enhancement of best practice.

  • Intended Use

    DART screening is intended to facilitate conversations between clinicians and patients, to enhance relief of physical and emotional distress and to identify patients who would benefit from referral to the specialized psychosocial oncology or palliative care services.

  • Target Audience

    While DART is predominately used in Cancer clinics it is also being adopted by other sites for distress screening. Any healthcare facility where early identification of distress to connect patients and families to the right supports is pertinent should consider adopting DART.

  • How DART Works

    DART monitors symptoms over time. Patients are asked to complete DART at the start of each clinic visit. DART takes 5-10 minutes to complete. Patients enter their symptom severity scores on a secure touch screen kiosk or an iPAD in their assigned clinic.

  • Who is currently using it?

    Currently all 12 sites within Princess Margaret use DART consistently, as well as in Radiation Review clinics. These sites include: Melanoma, Sarcoma, Eye, Endocrine, Lung, Head and Neck, Haematology, Gynaecology, Genitourinary, Gastrointestinal, Central Nervous System, and Breast.