Scaling up symptom screening for routine use in pediatric oncology: provincial implementation.

PURPOSE: The importance of routine symptom screening in pediatric oncology is increasingly being recognized. The Pediatric Oncology Group of Ontario (POGO) is therefore committed to facilitating its implementation province-wide. The objective was to establish common symptom screening practices in Ontario, Canada, by determining baseline implementation characteristics including initial enrollment cohorts, symptom screening frequency and screening duration. METHODS: POGO's Guidelines and Implementation Program convened an in-person focus group of site representatives, methodologists and a patient advocate. The focus group aimed to establish initial minimum characteristics of the symptom screening and management program: which patient cohorts to include, symptom screening reminder frequency and symptom screening duration. The nominal group technique and simple voting procedures were used. RESULTS: Using the nominal group technique with two rounds of voting, focus group members identified newly diagnosed or relapsed pediatric outpatients receiving ambulatory chemotherapy as the initial target cohort. Simple voting procedures determined that the initial minimum symptom screening frequency will be once weekly and that symptom screening will extend for 3 months. At 3 months, patients or families can opt to continue or stop. CONCLUSION: We convened a focus group to establish provincial minimum characteristics of a symptom screening and management program in pediatric oncology. The program will include outpatients who are newly diagnosed or relapsed receiving ambulatory chemotherapy. Symptom screening reminders will be sent weekly for 3 months. These efforts should improve quality of life of pediatric patients with cancer at the population level.