Enhancing provider engagement and accountability: A strategy for survivorship care plan implementation within a large hospital network.

56 Background: Challenges to Survivorship Care Plan (SCP) implementation persist and guidelines to facilitate provider engagement and accountability are needed. In 2014, Levine Cancer Institute (LCI), part of one of the largest Commission on Cancer (COC) hospital networks, instituted a SCP delivery model. The patient’s LCI or LCI-affiliated physician or advanced care provider (ACP) is responsible to create and deliver the SCP. This presentation updates and extends prior work presented at the 2017 ASCO Cancer Survivorship Symposium to demonstrate the utility of enhanced provider engagement and accountability in SCP program expansion at LCI. Methods: The Survivorship Section partnered with the Cancer Committee to develop a system to enhance provider engagement and accountability. Strategies to improve engagement included: emailed SCP metrics (monthly goals and volume reports) and poster presentations to demonstrate SCP value to Tumor Site Section Leaders (TSSLs), administrators and providers. Strategies to promote accountability included: (1) partnered with TSSLs to clarify SCP eligibility criteria, set monthly goals and identify methods to optimize delivery; (2) discussed SCP metrics within each TSSL to highlight participation rates of providers or clinics; (3) presented Section- and clinic-specific SCP performance at quarterly Cancer Committee, National Accreditation Program for Breast Cancer leadership and Operational meetings; and (4) required all newly hired outpatient ACPs to receive SCP training and included SCP delivery in yearly ACP goals. Results: Since 2014, the total number of SCPs, participating providers, clinics and cancer types has grown 25-, 17-, 7- and 22-fold, respectively. Conclusions: LCI developed a multilayer partnership strategy that enhanced engagement and accountability at the leadership and provider level. This partnership significantly increased numbers of SCPs delivered over four years and allowed us to meet COC goals. [Table: see text]

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Survivorship care plan (SCP) program development within a large hospital network.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.5_suppl.42 ◽

2017 ◽

Vol 35 (5_suppl) ◽

pp. 42-42

Author(s):

Natalie Garces ◽

Tara Eaton ◽

Beth York ◽

Chasse Margot Bailey-Dorton ◽

Wendy G. Brick

Keyword(s):

Program Development ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers ◽

Implementation Barriers ◽

Large Hospital ◽

Cancer Program ◽

Hospital Networks ◽

Survivorship Care Planning

42 Background: Barriers to SCP delivery are pervasive, with limited data available on strategies to address implementation barriers. Despite the variety of models for SCP-based survivorship care planning, there is a dearth of studies on SCP program development for larger hospital networks. Large networked hospital systems, including the Levine Cancer Institute (LCI), have unique challenges for implementing a SCP program. Methods: Beginning in 2014, LCI implemented a process for delivery of SCPs across its network of 8 Commission on Cancer accredited hospitals. Obstacles to implementation were evaluated and methods of establishing procedures for insuring SCP delivery were reviewed. Improvement in SCP delivery was measured over 3 years. SCP program development involved leveraging technology, developing processes for identifying eligible survivors, and engaging providers and practice managers in this key organizational initiative. Results: In 2014, the SCP program consisted of 3 advanced care providers (ACPs) in 3 LCI medical oncology clinics, delivering SCPs to 67 (2%) of the eligible 3,336 survivors. In the second year of implementation, 14 ACPs and 4 MDs delivered 348 (11%) SCPs to eligible survivors in 14 LCI clinics. By the end of the 2016 calendar year, it is estimated that > 1,029 SCPs ( > 25%) of eligible survivors will receive a SCP throughout the LCI hospital network. Conclusions: While challenging to deliver, SCPs are important both for cancer program accreditation and for communication between patients and physicians. At its large, multi-center cancer program, LCI has implemented a number of methods and protocols to insure that eligible patients receive informative and timely SCPs. LCI’s processes have resulted in an improvement in the number of SCPs delivered and have also served to eliminate obstacles to increasing the number of SCPs that will be delivered in the future. It is recommended that oncology practices consider the methods and interventions that LCI found helpful to improve SCP delivery in large hospital networks. It is also encouraged that oncology practices to continue to share their methods with other centers to promote eventual SCP delivery to eligible survivors.

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Correction to: Survivorship Care Plan Implementation in US Cancer Programs: a National Survey of Cancer Care Providers

Journal of Cancer Education ◽

10.1007/s13187-018-1450-5 ◽

2018 ◽

Vol 34 (3) ◽

pp. 623-623 ◽

Cited By ~ 1

Author(s):

Sarah A. Birken ◽

Sarah Raskin ◽

Yuqing Zhang ◽

Gema Lane ◽

Alexandra Zizzi ◽

...

Keyword(s):

National Survey ◽

Cancer Care ◽

Care Plan ◽

Survivorship Care Plan ◽

Survivorship Care ◽

Care Providers ◽

Plan Implementation

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Improving the survivorship care plan process across an academic and community cancer center.

Journal of Clinical Oncology ◽

10.1200/jco.2019.37.27_suppl.184 ◽

2019 ◽

Vol 37 (27_suppl) ◽

pp. 184-184

Author(s):

Robert Stuver ◽

Jennifer Faig ◽

Gerry Abrahamian ◽

Matthew M. Cadorette ◽

William M. Decaneas ◽

...

Keyword(s):

Care Plan ◽

Survivorship Care Plan ◽

Cancer Center ◽

Survivorship Care ◽

Educational Module ◽

Team Members ◽

Improvement Plan ◽

Management Personnel ◽

Cancer Types ◽

Disease Specific

184 Background: The goal of a survivorship care plan (SCP) is to improve provider coordination and engage patients in their care. Despite requirements from professional societies, implementation of SCPs is challenging. From April to July 2018, 36% of eligible patients received an SCP at our institution. We aimed to identify barriers to SCP completion and implement interventions to increase their delivery for all cancer types at our academic and community cancer sites. Methods: We created a survey to assess physician, nursing and trainee perceptions and identify barriers to SCP completion. The survey was sent to providers within our medical, surgical, and radiation oncology departments. Providers were asked to rate their satisfaction with our current SCP process and identify obstacles and solutions to achieve SCP completion. In response, we held meetings between oncology attendings, trainees, tumor registry staff, and health information management personnel to design an improvement plan. Results: Of 178 providers, 74 (41.6%) responded. Four percent were satisfied with our current process. The most frequently cited barriers were time (62.1%), lack of clarity regarding who completes the SCP (52%), and insufficient personnel (47.3%). The most frequently cited solutions were dedicated personnel (84.9%), disease-specific templates (61.6%), and education regarding SCPs (48.1%). Based on these results, we: (1) Streamlined our SCP process by entering a partially-templated SCP into an eligible patient’s electronic medical record by our tumor registrar; (2) Asked for disease-specific recommendations that can be included in the template; (3) Asked providers to identify additional team members who assist with SCP completion so that SCPs can be appropriately queued; and (4) Designed an online educational module. Conclusions: We identified multiple barriers to SCP completion at our institution. In response, we implemented a multifaceted improvement plan across our academic and community cancer sites. An analysis of its effects are forthcoming.

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