Reflections on the implementation of screening for distress (sixth vital sign) in Canada: key lessons learned

Background Accreditation bodies in the USA, the UK, and Europe have mandated that jurisdictions regularly screen patients for distress. While these requirements have been in place for some time, recent reports suggest that facilities still struggle to overcome implementation barriers. In Canada, a Screening for Distress (the sixth vital sign) Initiative was implemented in eight cancer treatment facilities in seven provinces. With national support and coordination from the Canadian Partnership Against Cancer, the initiative’s primary goal was to provide timely and appropriate response to cancer patients’ distress to improve the patient experience. Patient experience is defined as the sum of an individual’s perceptions, expectations and interactions related to his or her health and care throughout the cancer journey (CPAC 2012). The implementation included the application of evidence-informed tools by trained health care professionals to identify distress, facilitate intervention or referral, and enhance collaboration among health care providers to meet patient needs. Implementations have expanded in these facilities since the launch of the initiative and the success of this programmatic approach in Canada may assist other jurisdictions with successful implementation of Screening for Distress (sixth vital sign).