scholarly journals Accuracy and Thoroughness of Treatment Summaries Provided as Part of Survivorship Care Plans Prepared by Two Cancer Centers

2017 ◽  
Vol 13 (5) ◽  
pp. e486-e495 ◽  
Author(s):  
Amye J. Tevaarwerk ◽  
William G. Hocking ◽  
Jamie L. Zeal ◽  
Mindy Gribble ◽  
Lori Seaborne ◽  
...  
Keyword(s):  
Significant Proportion ◽  
Data Entry ◽  
Standard Of Care ◽  
Care Plan ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Cancer Centers ◽  
Treatment Summaries ◽  
Care Plans ◽  
Treatment Information

Purpose: Treatment summaries prepared as part of survivorship care planning should correctly and thoroughly report diagnosis and treatment information. Methods: As part of a clinical trial, summaries were prepared for patients with stage 0 to III breast cancer at two cancer centers. Summaries were prepared per the standard of care at each center via two methods: using the electronic health record (EHR) to create and facilitate autopopulation of content or using manual data entry into an external software program to create the summary. Each participant's clinical data were abstracted and cross-checked against each summary. Errors were defined as inaccurate information, and omissions were defined as missing information on the basis of the Institute of Medicine recommended elements. Results: One hundred twenty-one summaries were reviewed: 80 EHR based versus 41 software based. Twenty-four EHR-based summaries (30%) versus six software-based summaries (15%) contained one or more omissions. Omissions included failure to provide dates and specify all axillary surgeries for EHR-based summaries and failure to specify receptors for software-based summaries. Eight EHR-based summaries (10%) versus 19 software-based summaries (46%) contained one or more errors. Errors in EHR-based summaries were mostly discrepancies in dates, and errors in software-based summaries included incorrect stage, surgeries, chemotherapy, and receptors. Conclusion: A significant proportion of summaries contained at least one error or omission; some were potentially clinically significant. Mismatches between the clinical scenario and templates contributed to many of the errors and omissions. In an era of required care plan provision, quality measures should be considered and tracked to reduce rates, decrease inadvertent contributions from templates, and support audited data use.

Who is receiving survivorship care plans? Findings from the 2012 Livestrong survey.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 9608-9608
Author(s):  
Ruth Rechis ◽  
Carla Bann ◽  
Stephanie Nutt ◽  
Linda Squiers ◽  
Naveen Rao
Keyword(s):  
Medical Center ◽  
Care Plan ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Long Term Effects ◽  
Care Plans ◽  
Key Stakeholders

9608 Background: There are more than 14 million cancer survivors in the US – a number that is on the rise. Care coordination resources will be essential to provide support to this growing population. Key stakeholders, including the Commission on Cancer (CoC) and the Institute of Medicine, have proposed survivorship care plans (SCPs) as a way to extend support. However, limited research has been conducted to date on SCPs. Methods: In 2012, the LIVESTRONG Foundation (LIVESTRONG) administered a survey to understand the role of a treatment summary (TS) and SCPs and how they fit into survivors’ care. Logistic regression models were conducted to identify factors associated with receiving SCPs or TS. Results: 5,303 survivors responded to these questions (Table). While 92% of these respondents received information about where to return to for cancer check-ups, only 51% reported receiving a TS and 17% reported receiving a SCP. Survivors who were more likely to receive SCPs if they had a navigator (p<.001) and if they were male, Black, had finished treatment within the past year, or received care at a university-based medical center or community cancer center (p < 0.05). Also, those receiving a SCP were significantly more likely to have had a detailed discussion with a provider regarding long-term side effects, emotional needs, and lifestyle recommendations. Specifically, 60% of those with a SCP discussed long-term effects compared to 39% who did not. Conclusions: Results here indicate that few survivors receive SCPs but survivors reported benefits from receiving them. Currently many workflow barriers impede delivering SCPs, and LIVESTRONG is working with key stakeholders including the CoC to automate the LIVESTRONG Care Plan powered by Penn Medicine’s OncoLink through a registry and EMR system to understand how to address this issue. [Table: see text]

Systematic development of a a breast cancer survivorship program at a small independent oncology practice.

2016 ◽  
Vol 34 (3_suppl) ◽  
pp. 52-52 ◽  
Author(s):  
Cynthia Rogers ◽  
Shailesh R. Satpute
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Data Entry ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Survivorship Care Plans ◽  
Full Time ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care Plans

52 Background: It is widely accepted that providing survivorship care plans leads to improvements in outcomes for cancer survivors. Treatment summaries are now part of ASCO and NCCN survivorship guidelines. We faced a unique challenge of implementing the survivorship care plan at the Jones Clinic as a small independent practice. The Jones Clinic consists of three full time physicians and two full time nurse practitioners. We see approximately 850 new patients per year. Methods: As a part of ASCO’s quality training program, we focused on the stage I – III (early stage) breast cancer patients who completed their initial therapy. We formed a team, identified the barriers, created a flow diagram of the process, assigned roles for each individual member and finally implemented the process. Results: The major issues identified were lack of provision in the electronic medical record (EMR) system for survivorship and lack of standardized data entry process. We created a system in the EMR for survivorship data entry and extraction of such data in a document. Since July 2015, one hundred percent of breast cancer patients completing adjuvant therapy at the Jones Clinic have received a survivorship treatment summary and a plan of care. The care plan is also shared with their primary care provider. Importantly, creating a survivorship document required less than 10 minutes of the provider’s time. Conclusions: We are now able to provide our patients with a survivorship care plan and address survivorship issues within thirty days of completion of therapy. Creating the care plan requires minimal time from the providers. Our new process meets ASCO guidelines for survivorship care plans and no additional staffing was needed. We now plan to provide a survivorship care plan to all oncology patients treated with curative intent.

Developing a culturally and linguistically responsive survivorship care plan for breast cancer.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 146-146
Author(s):  
Kimlin Tan Ashing ◽  
Monica Rosales ◽  
Gingi Fulcher ◽  
Mayra Serrano ◽  
Jeffrey N. Weitzel ◽  
...  
Keyword(s):  
Health Care Professionals ◽  
Cultural Responsiveness ◽  
Advisory Council ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Preliminary Evaluation ◽  
Breast Cancers ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans

146 Background: African and Latina-American breast cancers patients (BCA) experience the greatest morbidity and mortality, suggesting a critical need for improved surveillance and quality care. The Institute of Medicine (IOM) and the Commission on Cancer (CoC) recommend that survivors receive personalized Treatment Summaries and Survivorship Care Plans (TSSCP) in order to facilitate best practice in clinical surveillance and follow-up care. This TSSCP template development study joined advocacy, scientific and medical communities to comprise a diverse advisory council (AC, N=38) to inform the development of the TSSCP-AA (African American) and TSSCP-S (Latino) templates targeting BCA. This abstract reports on the development, and presents the TSSCP-AA and TSSCP-S. Methods: The overall study was guided by the Shared Care and Psychooncology Models, and Contextual Model of Health Related Quality of Life. The AC provided input into the culturally relevant modifications of the American Society of Clinical Oncology (ASCO) TSSCP template to create the TSSCP-AA and TSSCP-S. Health care professionals enlisted from cancer centers and community hospitals (n=51) evaluated the TSSCP-AA and TSSCP-S templates on the following domains: content, clarity, utility, and cultural and socioecological responsiveness. Results: AC input revealed that the clinical (i.e., comorbidities) and cultural contexts (i.e., language, spirituality) must inform TS and SCP, respectively. Preliminary evaluation analyses documented that health professionals rated our TSSCP-AA and TSSCP-S templates as excellent to outstanding on content, clarity, utility, cultural responsiveness, and socioecological responsiveness (p<0.01). Conclusions: The evaluation results imply that the TSSCP-AA and TSSCP-S templates achieved cultural responsiveness with high acceptability and utility among professionals and survivors. We created both paper and electronic versions of theTSSCP-AA andTSSCP-S (English and bilingual English-Spanish formats) for providers to create individualized TSSCPs. Further, our TSSCP development approach can be adopted for TSSCP template development targeting ethnic/linguistic minority cancer survivors.

Innovation, education, and research: A multidisciplinary survivorship care model.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 10519-10519
Author(s):  
Hira Latif ◽  
Patrick Martone ◽  
James Edward Shaw ◽  
Eric Wisotzky ◽  
Asma Ali Dilawari
Keyword(s):  
Physical Function ◽  
Cardiovascular Health ◽  
The United States ◽  
Screening Tools ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans ◽  
Patient Reported

10519 Background: Advances in early detection, therapeutics, and an aging population are expected to lead to an increase in the number of cancer survivors in the United States to 20 million by year 2026. The Institute of Medicine and Commission on Cancer recommends delivery of survivorship care plans on completion of curative treatment. While models exist for high-quality survivorship care, institutions encounter barriers such as lack of resources and limited training in survivorship. Our institution piloted a unique model combining fellows’ education with guideline-driven recommendations from a multidisciplinary team to provide consolidated survivorship care. Methods: A survey for self-reported competence and experience was conducted amongst the hematology and oncology fellows at the MedStar Washington Hospital Center. A bimonthly clinic staffed by a medical oncologist, oncology fellow and a cancer rehabilitation fellow was initiated in September 2018. Didactic lectures, curriculum syllabus and recommended assessments were established. Screening tools for distress, patients’ confidence in knowledge about survivorship and physical function via PROMIS 20a were administered; clinical assessments including the “6-minute walk test” were used to assess cardiovascular health. Results: Most fellows had not encountered a survivor of lung (16%), GU (0%) and head and neck cancer (33%). Majority of the fellows had never delivered a survivorship care plan. Scores were low in competence and experience in survivorship. By December 2018, 15 patients with 17 diagnoses of cancer were referred to the clinic. 10 were survivors of hematologic malignancies while 7 were of solid tumors. The no-show rate was 40%. Fellows conducted the assessments and were supervised by an oncology attending. Of the 9 patients seen, 4 were referred for physical therapy; additional referrals for psychology and cardiology were frequent. Conclusions: A comprehensive multidisciplinary survivorship clinic focusing on fellows’ education is a feasible model for delivery of survivorship care and aims to bridge the gap in experience and competence of fellows. Future goals include re-assessment of patient-reported outcomes, physical function, and competence of fellows.

Implementing the Survivorship Care Plan

2021 ◽  
pp. 760-766
Author(s):  
Erin E. Hahn ◽  
Patricia A. Ganz
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Cancer Survivorship ◽  
Care Plan ◽  
Care Planning ◽  
Survivorship Care ◽  
Treatment Summaries ◽  
Care Plans ◽  
American Society ◽  
Survivorship Care Planning

There are many challenges associated with ensuring quality care for cancer survivors. Cancer patients often require treatment by multiple specialists (surgeons, radiation oncologists, medical oncologists) due to the use of multimodal therapies. After treatment has ended, cancer patients may be at risk for serious long-term and late effects of their disease and treatment. Unfortunately, the oncology care system often fails to provide education and guidance to patients at the end of active cancer treatment, in contrast to the more standardized communication at the time of diagnosis and initial treatment planning. Delivering high-quality, coordinated care during the posttreatment phase is critical to ensure the best possible patient outcomes. One of the proposed first steps in accomplishing this is the widespread implementation of cancer treatment summaries and survivorship care planning, a key recommendation of the 2006 Institute of Medicine report, From Cancer Patient to Cancer Survivor: Lost in Transition. This has been embraced by a number of leading organizations, including the American Society of Clinical Oncology (ASCO) and the Commission on Cancer. Survivorship care has also become an international priority, with organizations such as the U.K. National Cancer Survivorship Initiative and Organization of European Cancer Institutes championing the importance of survivorship care. This chapter provides an overview of the development and use of treatment summaries and survivorship care planning and briefly reviews research on care plans and the health policy impact of survivorship care plans as they relate to quality improvement activities that are underway.

scholarly journals Survivorship Programs and Care Plans in Practice: Variations on a Theme

2011 ◽  
Vol 7 (2) ◽  
pp. 70-75 ◽  
Author(s):  
Erin E. Hahn ◽  
Patricia A. Ganz
Keyword(s):  
Los Angeles ◽  
Cancer Survivorship ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans ◽  
Practice Variations ◽  
Variations On A Theme

This study looks at four Los Angeles–based cancer survivorship programs and finds that the Institute of Medicine–recommended survivorship care plan document can be successfully adapted for use in varied settings to inform and educate both patients and providers.

Evaluating survivorship cancer care through quality improvement programs.

2012 ◽  
Vol 30 (34_suppl) ◽  
pp. 112-112
Author(s):  
Guadalupe R. Palos ◽  
Fran Zandstra ◽  
Ludivine Russell ◽  
Jacklyn J. Flores ◽  
Katherine R. Gilmore ◽  
...  
Keyword(s):  
Electronic Medical Records ◽  
Medical Records ◽  
Compliance Rate ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Full Time ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans ◽  
Improvement Programs

112 Background: The Institute of Medicine noted cancer survivors’ care may be improved by providing each with a cancer survivorship care plan (CSCP). Recently, numerous versions of CSCPs have emerged; however, evidence-based processes to evaluate their use and quality in providing personalized survivorship care have yet to be implemented. Here, we describe our efforts to use the approach recommended by the American Society of Clinical Oncology (ASCO) Quality Oncology Practice Initiative (QOPI) to track and report the compliance rate for using electronic CSCPs in our survivorship clinics. Methods: The criteria used to conduct our audit evolved from the QOPI template, which included selection of survivors seen in 7 different out-patient survivorship clinics within a specific 6-month period, identification of denominators and numerators unique to each clinic, and determination of the number of records to audit based on the number of full-time providers in each clinic. Next, we established the target condition, method(s) used for data collection, appropriate measures, and other criteria used in the QOPI. All data were obtained from our CSCPs’ mined data, institutional electronic medical records, and scheduling systems. Results: From December 1, 2011, to May 31, 2012, we conducted an electronic medical records audit to determine the compliance rate for issuing survivorship care plans in 7 clinics. The survivorship clinics included breast, colorectal, endocrine (thyroid), genitourinary, gynecology, head/neck, and melanoma. A total of 3,274 electronic medical records were reviewed. 40 providers issued a total of 2,761 electronic CSCPs within 30 days of the arrived appointment. The compliance rate per clinic ranged from 64.5% to 94.7% (X=84.5%). Conclusions: We found the QOPI process to be user-friendly and applicable to our compliance monitoring effort. All data were extracted from electronic tools, thus ensuring the processes used were reliable, reproducible, and reasonably consistent across clinics. Further examination is warranted to determine characteristics of clinics with high- vs. low-compliance rates and their impact on survivors’ outcomes as related to specific CSCP recommendations.

Who is receiving survivorship care plans? Findings from the 2012 LIVESTRONG survey.

2013 ◽  
Vol 31 (31_suppl) ◽  
pp. 26-26
Author(s):  
Ruth Rechis ◽  
Stephanie Nutt ◽  
Carla Bann ◽  
Linda Squiers ◽  
Naveen Rao
Keyword(s):  
Medical Center ◽  
Care Plan ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Long Term Effects ◽  
Care Plans ◽  
Key Stakeholders

26 Background: There are more than 14 million cancer survivors in the US – a number that is on the rise. Care coordination resources will be essential to provide support to this growing population. Key stakeholders, including the Commission on Cancer (CoC) and the Institute of Medicine, have proposed survivorship care plans (SCPs) as a way to extend support. However, limited research has been conducted to date on SCPs. Methods: In 2012, the LIVESTRONG Foundation (LIVESTRONG) administered a survey to understand the role of a treatment summary (TS) and SCPs and how they fit into survivors’ care. Logistic regression models were conducted to identify factors associated with receiving SCPs or TS. Results: 5,303 survivors responded to these questions. While 92% of these respondents received information about where to return to for cancer check-ups, only 51% reported receiving a TS and 17% reported receiving a SCP. Survivors who were more likely to receive SCPs if they had a navigator (p<.001) and if they were male, black, had finished treatment within the past year, or received care at a university-based medical center or community cancer center (p < 0.05). Also, those receiving a SCP were significantly more likely to have had a detailed discussion with a provider regarding long-term side effects, emotional needs, and lifestyle recommendations. Specifically, 60% of those with a SCP discussed long-term effects compared to 39% who did not. Conclusions: Results here indicate that few survivors receive SCPs but survivors reported benefits from receiving them. Currently many workflow barriers impede delivering SCPs, and LIVESTRONG is working with key stakeholders including the CoC to automate the LIVESTRONG Care Plan powered by Penn Medicine’s OncoLink through a registry and EMR system to understand how to address this issue.

Implementation of survivorship care plans in the pediatric oncology clinic.

2018 ◽  
Vol 36 (7_suppl) ◽  
pp. 55-55 ◽  
Author(s):  
Christine Moore Smith ◽  
Barron L. Patterson ◽  
Debra L. Friedman
Keyword(s):  
Pediatric Oncology ◽  
Standard Of Care ◽  
Primary Care Providers ◽  
Care Plan ◽  
Survivorship Care Plan ◽  
Cancer Center ◽  
Survivorship Care ◽  
Care Providers ◽  
Care Plans

55 Background: Quality survivorship care and follow up have been well described in the pediatric oncology population to improve overall health of cancer survivors. Typically, a key component is the delivery of a survivorship care plan (SCP) in a dedicated survivorship program. Creation of an SCP in the immediate post-treatment period has not been commonly adopted. To address the Commission on Cancer's (CoC) requirement to provide SCPs within six months of ending therapy, our pediatric oncology clinic has used quality improvement (QI) methods to incorporate SCPs into clinic workflow with subsequent survivorship program referral. Our aim is to meet the CoC’s benchmark of 50% of eligible patients receiving SCPs by December 31, 2017. Our secondary goal is to improve the timeliness of delivery to patients, families, and primary care providers (PCP). Methods: Registry data from our cancer center was utilized to identify eligible patients. Upcoming appointments were then identified for a panel of eligible patients using the electronic medical record (EMR). Providers use a standardized SCP template which includes the components required by the CoC. The SCP is then reviewed with families, electronically sent to the PCP, and saved in the EMR. Evaluation of the process included subjective feedback from providers and Plan-Do-Study-Act cycles. Based on this feedback and cycles, iterations of the template have been progressively streamlined and the EMR panel has been updated. Results: Care plan creation and delivery is ongoing. At baseline, 28% of eligible patients had SCPs previously created in the survivorship program. After implementation of our QI methods, to date, we have increased the proportion of eligible patients with an SCP to 40.3%, approaching our goal of 50% by December 31, 2017. We have also decreased the time from end of therapy to delivery of a care plan from 22.9 months to 14 months. This is expected to further improve as the process continues. Conclusions: The QI process has been successful in implementing a new standard of care for delivery of SCPs. Ongoing use of QI methods will increase compliance with the CoC standards and result in improved survivorship care.

Failing to Plan Is Planning to Fail: Improving the Quality of Care With Survivorship Care Plans

2006 ◽  
Vol 24 (32) ◽  
pp. 5112-5116 ◽  
Author(s):  
Craig C. Earle
Keyword(s):  
Care Plan ◽  
Survivorship Care Plan ◽  
Premature Menopause ◽  
Survivorship Care Plans ◽  
Primary Therapy ◽  
Institute Of Medicine ◽  
Survivorship Care ◽  
Care Plans ◽  
Important Message ◽  
The Creation

The recent Institute of Medicine report “From Cancer Patient to Cancer Survivor: Lost in Transition” recommended the creation of survivorship care plans for patients as they complete primary therapy for cancer to ensure clarity for all involved about patients’ diagnoses, treatments received, and surveillance plans. Any previously existing follow-up guidelines for cancer survivors have been largely restricted to surveillance for recurrence of the primary disease. An important message of the Institute of Medicine report is that survivorship care plans must surpass this and address the chronic effects of cancer (pain, fatigue, premature menopause, depression/anxiety), monitoring for and preventing late effects like osteoporosis, heart disease, and second malignancies, and promoting healthy lifestyles. It should explicitly identify the providers responsible for each aspect of ongoing care and provide information on resources available for psychosocial and other practical issues that may arise as a result of the prior cancer diagnosis. Although having some sort of a plan is clearly necessary to achieve high quality care, there are practical barriers to formal off-treatment consultations and the creation of written documents that may become part of the medical record. This article reviews the elements of the proposed survivorship care plan and discusses areas of research and development needed to make them part of standard oncology practice.

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