Identifying Strategies for Robust Survivorship Program Implementation: A Qualitative Analysis of Cancer Programs

2021 ◽  
Author(s):  
Soohyun Hwang ◽  
Burcu Bozkurt ◽  
Tamara Huson ◽  
Sarah Asad ◽  
Lauren Richardson ◽  
...  
Keyword(s):  
Program Implementation ◽  
Health Care Professionals ◽  
Implementation Strategies ◽  
The United States ◽  
Survivorship Care ◽  
Team Members ◽  
Care Plans ◽  
Care Processes ◽  
Key Stakeholders ◽  
Template Analysis

PURPOSE The Commission on Cancer seeks to promote robust survivorship programs among accredited cancer programs. In practice, cancer programs' survivorship programs range from cursory (eg, developing care plans without robust services) to robust (eg, facilitating follow-up care). To inform cancer programs' future efforts, in this study, we identified the implementation strategies that cancer programs used to achieve robust survivorship programs, distinguishing them from cursory programs. METHODS We sampled 39 cancer programs across the United States with approaches to survivorship program implementation ranging from cursory to robust on the basis of LIVESTRONG survivorship care consensus elements. Within sampled cancer programs, we conducted in-depth semistructured interviews with a total of 42 health care professionals. We used template analysis to distinguish implementation strategies used in cancer programs with robust survivorship programs from strategies that yielded cursory survivorship programs. RESULTS Cancer programs with robust survivorship programs established clear systems survivorship care and formal committees to improve the survivorship care processes. They sought buy-in from multiple stakeholders to leverage cancer program resources and defined clear roles with shared accountability among multidisciplinary groups. By contrast, cancer programs with cursory survivorship programs reported less consistency in survivorship care processes and lacked buy-in from key stakeholders. They had limited resources, faced persistent structural concerns, and had insufficient clarity in roles among team members. CONCLUSION Accrediting bodies may consider incorporating the implementation strategies that robust survivorship programs have used as guidance for supporting cancer programs in operationalizing survivorship care and evaluating the use of these strategies during the accreditation and review process.

Strategies for comprehensive implementation of survivorship care: A qualitative analysis of CoC-accredited cancer programs.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 209-209
Author(s):  
Soohyun Hwang ◽  
Burcu Bozkurt ◽  
Tamara Huson ◽  
Sarah Asad ◽  
Lauren Richardson ◽  
...  
Keyword(s):  
Program Implementation ◽  
Team Member ◽  
Structured Interviews ◽  
Multiple Stakeholders ◽  
Record System ◽  
Team Members ◽  
Upper Management ◽  
Care Plans ◽  
Key Stakeholders

209 Background: The Commission on Cancer (CoC) seeks to promote comprehensive approaches to implementing survivorship programs among accredited cancer programs. In practice, cancer programs’ approaches range from cursory (e.g., developing care plans without robust services) to comprehensive (e.g., facilitating follow-up care). This study identified strategies that were unique to cancer programs with comprehensive approaches to implementing survivorship programs. Methods: We sampled 39 CoC-accredited cancer programs with approaches to survivorship program implementation ranging from cursory to comprehensive, as reported in CoC annual surveys. Within sampled cancer programs, we conducted in-depth semi-structured interviews with a total of 42 healthcare professionals (1-2/program). We identified strategies unique to cancer programs with comprehensive approaches by comparing them to cancer programs with cursory approaches. Results: Cancer programs with comprehensive approaches to implementing survivorship programs had formal committees with ample opportunities to evaluate the progress, revise roles, and acquire multiple stakeholders’ support. Keeping a good record system enabled these cancer programs to meet accreditation requirements and improve processes. Buy-in from upper management and key physicians was deemed crucial in leveraging cancer program resources. These programs also had clear roles with shared accountability among multidisciplinary groups. Like cancer programs with comprehensive approaches to implementing survivorship programs, many cancer programs with cursory approaches also had formal committees; however, cancer programs with cursory approaches lacked buy-in from key stakeholders, relying on few staff or a champion for implementation. Cancer programs with cursory approaches had limited resources, cumbersome processes, and team members with unclear roles. Conclusions: Cancer programs with comprehensive approaches to survivorship program implementation gained broad stakeholder buy-in and established clear team member roles with shared accountability. Study findings will inform more than 1500 CoC-accredited US cancer programs’ approaches to implementing survivorship programs. At the conference, we will have results from quantitative and measures validation companion studies.

scholarly journals Use of Survivorship Care Plans in the United States: Associations With Survivorship Care

2013 ◽  
Vol 105 (20) ◽  
pp. 1579-1587 ◽  
Author(s):  
L. P. Forsythe ◽  
C. Parry ◽  
C. M. Alfano ◽  
E. E. Kent ◽  
C. R. Leach ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

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]

scholarly journals Use of Survivorship Care Plans and Analysis of Patient-Reported Outcomes in Multinational Patients With Lung Cancer

2016 ◽  
Vol 12 (5) ◽  
pp. e527-e535 ◽  
Author(s):  
Abigail T. Berman ◽  
Cristina M. DeCesaris ◽  
Charles B. Simone ◽  
Carolyn Vachani ◽  
Gloria DiLullo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Patient Reported Outcomes ◽  
Primary Lung Cancer ◽  
The United States ◽  
Cancer Center ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Cognitive Changes ◽  
Care Plans ◽  
Patient Reported

Purpose: Lung cancer is the leading cause of cancer death and is a significant source of morbidity. Patient-reported outcomes (PROs) have been shown to be prognostic for survival. We have analyzed emerging patterns of longitudinal PROs collected in the development of survivorship care plans (SCPs). Methods: OncoLife and the LIVESTRONG Care Plans are Internet-based programs designed to generate unique SCPs. We selected SCPs from patients identifying as survivors of primary lung cancer. Patient-reported demographics and treatment and toxicity data were examined. Effects were categorized by the physiologic system that they affected. Results: Six hundred eighty-nine plans were created for users self-identifying as survivors of primary lung cancer. Average time from diagnosis to reporting was 1.68 years (range, 0 to 24 years). Most were white (85.9%), well educated (61.1% “some college” or higher), and lived in the United States (90.7%). Patients underwent chemotherapy (75.8%), radiotherapy (54.7%), and surgery (54.4%). Neurocognitive symptoms (eg, fatigue, cognitive changes) were the most common (48.8%), especially among those receiving chemotherapy, followed by musculoskeletal/dermatologic symptoms (14.1%) and thoracic symptoms (13.5%). Only 11.2% were initially offered an SCP. Of those offered SCPs, 54.5% were offered by their health care provider, and most often were at a non–university-based cancer center (66.2%). Conclusion: For patients with lung cancer worldwide, it is feasible to obtain PROs and to create SCPs through an Internet-based program. As patients with lung cancer achieve improved survival, further attention should be paid to PROs. Surprisingly, neurocognitive symptoms seem to be the most common issues and therefore the most important to address. Increased effort should be made to provide SCPs, particularly in urban and university cancer center settings.

The views of bowel cancer survivors and health care professionals regarding survivorship care plans and post treatment follow up

2009 ◽  
Vol 3 (2) ◽  
pp. 99-108 ◽  
Author(s):  
Carl Baravelli ◽  
Meinir Krishnasamy ◽  
Carmel Pezaro ◽  
Penelope Schofield ◽  
Kerryann Lotfi-Jam ◽  
...  
Keyword(s):  
Health Care ◽  
Cancer Survivors ◽  
Health Care Professionals ◽  
Bowel Cancer ◽  
Post Treatment ◽  
Survivorship Care Plans ◽  
Survivorship Care ◽  
Care Plans

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.

An educational program to improve cancer survivorship research.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 94-94
Author(s):  
Guadalupe R. Palos ◽  
Patricia Chapman ◽  
Katherine Ramsey Gilmore ◽  
Paula A. Lewis-Patterson ◽  
Maria Alma Rodriguez
Keyword(s):  
Public Health ◽  
Health Care ◽  
Undergraduate Students ◽  
Health Care Professionals ◽  
Scientific Conference ◽  
Advanced Degree ◽  
Survivorship Care ◽  
Term Care ◽  
Care Plans ◽  
Level Of Satisfaction

94 Background: ASCO has recognized the need to expand its educational portfolio to focus on long-term care of cancer survivors. Academic programs across health care professions overlook this topic in their curricula. To address this gap, we developed a survivorship research internship for undergraduate students enrolled in public health or health education programs. Here we present the results of an evaluation to assess the level of satisfaction of trainees and improve the curriculum. Methods: All students who completed the internship were eligible to participate in the evaluation. The authors conducted the survey using an electronic data system. Respondents were asked to rate their level of satisfaction with the curriculum and specific assignments, i.e. conducting their own survivorship research project, taking classes about PubMed or EndNotes, and abstracting data from medical records to use in survivorship care plans. Other measures were whether a trainee had written/published an abstract/manuscript, pursued an advanced degree, or obtained a job in health care after completing the program. Descriptive statistics were used to summarize results. Results: An 85% response rate was achieved (34/40 respondents). The majority were female (82.4%), Caucasian (56.3%), and enrolled in public health programs (41.2%). Almost all respondents (90.9%) strongly agreed or agreed they had a better understanding of the process needed to conduct survivorship research. 50.0% reported being most satisfied with the internship experience. 36.4% reported data abstraction and participating in PubMed or EndNotes classes were least useful. 35.3% reported observing health care professionals in the clinical setting was the most useful. 88.2% strongly agreed or agreed that the training was useful in their current work position.18.8% have achieved advanced degrees in medicine, nursing, or public health. Two of the 34 trainees have published a paper in a peer-reviewed journal or presented a poster at a scientific conference. Conclusions: Results indicated the vast majority of trainees had a positive experience engaging in the survivorship research internship. This strategy is one method that can be used to build and enhance education in survivorship care and research.

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.

scholarly journals Challenges for Latina Breast Cancer Patient Survivorship Care in a Rural US-Mexico Border Region

2021 ◽  
Vol 18 (13) ◽  
pp. 7024
Author(s):  
Eunjeong Ko ◽  
Veronica Cardenas ◽  
María Luisa Zúñiga ◽  
Susan I. Woodruff ◽  
Viviane Rodriguez ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Health Care ◽  
Health Care Professionals ◽  
Access To Health Care ◽  
Border Region ◽  
Survivorship Care ◽  
Breast Cancer Patients ◽  
Care Plans ◽  
Mexico Border ◽  
Us Mexico Border

Rural US Latina breast cancer patients experience language barriers, health literacy issues, and limited access to health care resources that negatively impact survivorship care. This study explored the challenges to survivorship care for rural Latina breast cancer (BC) patients and approaches to supporting survivorship care plans (SCP) from the stakeholders’ perspectives. Data were collected via eight focus groups (n = 40) and individual interviews (n = 4) with Latina BC patients, family caregivers, and health care professionals in a rural US-Mexico Border region. Interviews were audio-taped, transcribed, translated, and analyzed using thematic analysis. Themes related to the patient’s SCP challenges included: (1) lack of knowledge of treatment information, (2) lack of proactive health behavior, (3) gaps in information for care coordination, (4) psychological distress, and (5) difficulty retaining health information. Respondents expressed that the SCP document could fill patient information gaps as well as support patient communication with their clinicians and family. Rural BC patients demonstrated an acute need for information and active engagement in their survivorship care. The findings indicate the importance of addressing challenges for survivorship care on multiple dimensions: Cognitive, behavioral, social, and structural. Developing a culturally tailored SCP intervention will be imperative to support survivorship care.

scholarly journals Enhancing Survivorship Care Planning for Patients With Localized Prostate Cancer Using a Couple-Focused mHealth Symptom Self-Management Program: Protocol for a Feasibility Study (Preprint)

2017 ◽  
Author(s):  
Lixin Song ◽  
Kaitlyn L Dunlap ◽  
Xianming Tan ◽  
Ronald C Chen ◽  
Matthew E Nielsen ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
The United States ◽  
Localized Prostate Cancer ◽  
Self Management ◽  
Survivorship Care Plan ◽  
Care Planning ◽  
Survivorship Care ◽  
Care Plans ◽  
Secondary Outcomes ◽  
Survivorship Care Planning

BACKGROUND This project explores a new model of care that enhances survivorship care planning and promotes health for men with localized prostate cancer transitioning to posttreatment self-management. Survivorship care planning is important for patients with prostate cancer because of its high incidence rate in the United States, the frequent occurrence of treatment-related side effects, and reduced quality of life (QOL) for both men and their partners. A key component of comprehensive survivorship care planning is survivorship care plans (SCPs), documents that summarize cancer diagnosis, treatment, and plans for follow-up care. However, research concerning the effectiveness of SCPs on patient outcomes or health service use has thus far been inconclusive. SCPs that are tailored to individual patients’ needs for information and care may improve effectiveness. OBJECTIVE This study aims to examine the feasibility of an enhanced survivorship care plan (ESCP) that integrates a symptom self-management mHealth program called Prostate Cancer Education and Resources for Couples (PERC) into the existing standardized SCP. The specific aims are to (1) examine the feasibility of delivering ESCPs and (2) to estimate the magnitude of benefit of ESCPs. METHODS We will use a two-group randomized controlled pretest-posttest design and collect data at baseline (T1) and 4 months later (T2) among 50 patients completing initial treatment for localized prostate cancer and their partners. First, we will assess the feasibility of ESCP by recruitment, enrollment, and retention rates; program satisfaction with the ESCP; and perceived ease of use of the ESCP. To achieve the secondary aim, we will compare the ESCP users with the standardized SCP users and assess their primary outcomes of QOL (overall, physical, emotional, and social QOL); secondary outcomes (reduction in negative appraisals and improvement in self-efficacy, social support, and health behaviors to manage symptoms); and number of visits to posttreatment care services between T1 and T2. We will assess the primary and secondary outcomes using measurements with sound psychometrical properties. We will use a qualitative and quantitative mixed methods approach to achieve the research aims. RESULTS This project is ongoing and will be completed by the end of 2018. CONCLUSIONS The results from this study will help design a definitive randomized trial to test the efficacy of the ESCPs, a potentially scalable program, to enhance supportive care for prostate cancer patients and their families.

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