• engages and supports patients in managing their illness and health; and

  • systematically following up on, reevaluating, and adjusting plans.

Multiple organizations could significantly influence adherence to this standard of care. NCI, as the nation’s leader in cancer care, could include requirements for addressing psychosocial health needs in all of its protocols; standards for designating clinical or comprehensive cancer centers; and other programs, such as its Quality of Cancer Care Initiative. NCI also could work with other organizations in the public and private sectors to incorporate psychosocial health care into existing cancer care initiatives, such as the Centers for Disease Control and Prevention’s National Comprehensive Cancer Control Program and the Veterans Health Administration’s National Cancer Strategy. Private-sector leaders in cancer care could do the same. For example, standards-setting organizations such as NCCN and the American College of Surgeons’ Commission on Cancer could incorporate the committee’s recommended standard and its components into their own standards. Funders of leading initiatives to improve the quality of cancer care also could incorporate this standard into their programs.

Because individual clinical practices vary by their setting and patient population as well as by available resources in their practice and local community, how individual health care practices implement the standard of care and the level at which it is done will likely vary. Nevertheless, it is possible for all providers to meet this standard in some way. Examples of how some cancer care providers are doing so today and suggestions as to how others could do so, even with limited resources, are described in the next chapter. What organizations implementing this standard today have in common is attention to how care is delivered at their practice settings and a willingness to redesign care processes when needed—characteristics that require strong leadership, well known as a critical factor in the success of any major change initiative or quality improvement effort (Burns, 1978; Bodenheimer et al., 2004; National Institute of Standards and Technology, 2007).



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