Managing symptoms during cancer treatments: evaluating the implementation of evidence-informed remote support protocols.

Background: Management of cancer treatment-related symptoms is an important safety issue given that symptoms can become life-threatening and often occur when patients are at home. With funding from the Canadian Partnership Against Cancer, a pan-Canadian steering committee was established with representation from eight provinces to develop symptom protocols using a rigorous methodology (CAN-IMPLEMENT©). Each protocol is based on a systematic review of the literature to identify relevant clinical practice guidelines.

Consensus recommendations for the management of constipation in patients with advanced, progressive illness.

Constipation is a highly prevalent and distressing symptom in patients with advanced, progressive illnesses. Although opioids are one of the most common causes of constipation in patients with advanced, progressive illness, it is important to note that there are many other potential etiologies and combinations of causes that should be taken into consideration when making treatment decisions. Management approaches involve a combination of good assessment techniques, preventive regimens, appropriate pharmacological treatment of established constipation, and frequent monitoring.

An interdisciplinary team communication framework and its application to healthcare 'e-teams' systems design.

Background: There are few studies that examine the processes that interdisciplinary teams engage in and how we can design health information systems (HIS) to support those team processes. This was an exploratory study with two purposes: (1) To develop a framework for interdisciplinary team communication based on structures, processes and outcomes that were identified as having occurred during weekly team meetings. (2) To use the framework to guide 'e-teams' HIS design to support interdisciplinary team meeting communication.

Adopting and introducing new technology to improve patient care: a wedding of clinicians and informatics specialists.

The BC Cancer Agency sees 128,172 patients per year, of which 2,186 are referred to the Patient Symptom Management/Palliative Care (PSMPC) clinics for tertiary symptom management. Other than at the PSMPC clinics, screening for symptom distress is extremely variable because there is no systematic assessment protocol. In a recent audit of patients coming to the Cancer Agency, approximately 64% of patients reported experiencing a moderate to severe level of symptom distress.

Development and reliability testing of the Victoria Bowel Performance Scale (BPS).

With changes in bowel function being a common and often distressful issue for palliative care patients, the ability to easily monitor and record changes in bowel status would be helpful in addressing quality of care. Most bowel tools record either constipation or diarrhea, but not both. A new tool, the Victoria Bowel Performance Scale (BPS), was designed as an ordinal nine-point scale from -4 (severe constipation) to +4 (severe diarrhea) and includes three parameters: visual stool characteristics, bowel pattern, and ability to control defecation.