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  • Author: Helen Tackitt x
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Bridgett Harr, Joanna Bodmann and Helen Tackitt

Background: Survivorship care (SC) has evolved since its inception, as there are many approaches to provide care for the cancer survivor. In review of disease-specific programs offered, it was determined there were varying levels of commitment and resources within the same institution. Due to Commission on Cancer (CoC) requirements for eligible patients to be offered SC, a project was undertaken to standardize SC by: (1) establishing a comprehensive, standardized assessment for SC, (2) delivering consistent SC across disease groups, (3) encouraging evidence-based multidisciplinary management, and (4) meeting CoC standards of SC plan (SCP) delivery. Methods: SC is delivered by embedded, disease-specific advanced practice providers (APPs). All patients receive a personalized SCP, along with general survivorship education. Due to differences in resources and survivorship expertise, not all patients receive the same care quality. An APP committee was created to review the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Survivorship and develop a comprehensive program. A questionnaire was created to address survivorship-specific concerns. An order set was created to highlight available resources. Additionally, evidence-based practice guidelines were created for each survivorship concern to assist the provider in identification and management. This was added to standard materials, and tailored education is given based on concerns identified during the visit. Referrals and orders are placed as appropriate. Results: Across the institution, SCP delivery is on track to meet CoC standards for 2018. A database has been developed to track and audit completion of SCP delivery. The standardized survivorship questionnaire was implemented to enhance the meaningfulness of the survivorship visit. This was executed during the 4th quarter of this year with review and revision underway. Conclusions: Standardized delivery of SC is improving with positive feedback from the patients. The survivorship questionnaire and supporting materials have been well-received by APP staff to assist in quality care. Some areas continue to lack adequate resources for implementation and will pose challenges in the future to meet accrual metrics. Future goals include creating pre-visit electronic questionnaires and repeat assessments to address survivors’ evolving needs. Prospective data will be collected on survivors to assess unmet needs and population differences.