Case Synopsis

Health Promotion Specialist Lisa Grey is faced with the task of strengthening patient and health care team culture using the Edmonton Symptoms Assessment Screening (ESAS) tool. ESAS is a standardized symptom screening tool used in health care settings across Ontario and is completed by patients at each clinic visit. The tool measures and tracks a patient’s symptom severity relating to nine common cancer symptoms. Symptoms are an indication of the progression of cancer and patient health status. ESAS gives an opportunity to identify symptoms earlier on, prevent emergency admission, and manage symptoms such as pain (Barbera et al., 2012; Barbera et al., 2015). The percentage of total cancer patients who were screened at least once with ESAS had declined at the London Regional Cancer Program; screening rates were below the provincial target of 70% and the provincial average of 58.4% (Cancer Care Ontario, 2014). Grey oversees five work streams in an effort to change attitudes and beliefs among patients and health care employees, and highlight the value of using ESAS on a consistent basis.

Case Objectives

  1. Understand the factors that influence patient and health care team culture.
  2. Develop a strategy based on survey and focus group feedback.
  3. Analyze and develop applicable health communication methods.
  4. Apply a behaviour change model to the case.

Case Study Questions

  1. What are health communication methods and strategies that can be used to improve patient culture relating to participating in symptom screening?
  2. What are the advantages and disadvantages of using these methods and strategies?
  3. What partnerships are necessary to facilitate health care team (e.g. management, clerks, volunteers, nurses, physicians, and other allied health) culture changes?
  4. Identify the key tensions related to the health care team culture.
  5. Develop a strategy to address the issues in ‘Next Steps’ to increase symptom screening and management use among health care teams.


patient culture, health care team culture, symptom screening and management, ESAS

Additional Author Information

Vanessa Yeboah, BScN, RN, MPH

Melissa Beilhartz, BA, Publicity & Marketing Specialist

Millie Litt, MHSc, CHE, Manager

Mark Speechley, PhD, Professor



Recommended Citation

Yeboah, V., Beilhartz, M., Litt, M., Speechley, M. (2016). Shifting Culture Between Patients and Health Care Teams To Impact Symptom Screen and Management. in: Terry, A.L. & John-Baptiste, A. [eds] Western Public Health Casebook 2016. London, ON: Public Health Casebook Publishing.