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

Abstract

Purpose: This qualitative study examined cancer survivorship programs at four health care organizations in Los Angeles County, CA: an academic medical center, a community hospital, a primary-care medical group, and a county hospital. The purpose was to describe the successful implementation of four distinctly different models of care, focusing on the creative development and use of the Institute of Medicine-recommended survivorship care plan (SCP) document in each setting. Methods:In-depth semistructured interviews were done with survivorship teams to characterize each program and the development and use of the SCP at each institution.Results: Each survivorship program has developed and implemented unique types of SCP documents. Specifically, a comprehensive SCP at the academic center, completed by the clinical team, which covers many facets of cancer survivorship; a patient-directed SCP at the community hospital, completed by the survivor with assistance of an oncology nurse and focused on treatment history and appropriate surveillance; an adapted ASCO SCP template at the primary-care medical group, completed via a partnership with contracted oncologists and focused on the treatment history, surveillance, and shared care between oncology and primary care; an adapted ASCO SCP template at the county hospital, completed by the survivorship nurse practitioner and focused on patient education, post-treatment care, and institutional care coordination. Conclusion:The SCP document is a flexible tool that can be successfully adapted for use in extremely varied settings, from primary care to hospitals, to inform and educate patients and providers alike.

Views of Family Physicians about Survivorship Care Plans to Provide Breast Cancer Follow-Up Care: Exploration of Results from a Randomized Controlled Trial

“…Several studies have focused on what scps should entail [8][9][10][11][12][13] , their rationale and strategies for their implementation 14,15 , or obstacles to their completion 10,[15][16][17][18][19][20] . Other studies have described the perspectives of patients about, and patient and health care provider support for or satisfaction with, scps [21][22][23][24][25][26][27][28][29][30][31] .…”

Wellness beyond Cancer Program: Building an Effective Survivorship Program

“…A risk-stratified approach is used in the pediatric cancer population: Patients considered low-risk are discharged back to their pcp; moderate-risk patients continue in a shared-care model; and those at high risk continue with their oncologist 9,10 . That approach has been further refined to utilize a nurse practitioner (np)-led survivor clinic 9,11 . No model has been shown to be superior 12-14 . In the adult population, models of survivorship care are heterogeneous.…”

‘They’re survivors physically but we want them to survive mentally as well’: health care professionals’ views on providing potential late effect information

“…Published literature indicates a growth in the development and implementation of SCPs internationally [3][4][5][6][7] but assessment of their impact on patient experience is rare. Van de Poll-Franse and colleagues have published their protocol of a randomized controlled trial (RCT) evaluating the impact of an SCP on gynaecological cancer survivors' satisfaction with information disclosure and care, quality of life, illness perception, and health care use [8] but there are no results to date.…”