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.
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.
DART is linked to inter-professional supportive care pathways and has been created for the assessment of the physical, practical, and psychosocial health of patients.
What it Includes
The IT programming and triaged care pathways based on tested response algorithms.
A protocol including frameworks, business plans, policies and procedures for distress screening implementation and evaluation.
Inter-professional education modules for improved standards in care and enhanced evidence based practice across disciplines.
A self-management tool for patients to mobilize and access patient education resources based on their identified need.
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.
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.
Upon completing DART the patient takes their easy-to-read print-out for discussion. The assessments are reviewed by the patients’ healthcare team, a copy is saved in their patient record, and some assessment scores are sent to external entities such as Cancer Care Ontario (CCO).
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. We have been successful at ensuring that the screening rates remain over 70%, with rates as high as 85% in some months, based on internal hospital reporting.