Challenges in the implementation of survivorship care plans in an NCI-designated cancer center.

Abstract

68 Background: The development and initiation of Survivorship Care Plans (SCPs) across all disease sites was identified as a Strategic Initiative Goals for 2015 by the Clinical Cancer Committee. The 2012 Commission on Cancer requirements for certification provided an additional incentive to meet this goal. Establishing a process that includes the development and distribution of a SCP’s within the electronic medical record (EMR) is necessary to improve on the completion of SCP’s and to improve the utilization of surveillance tests in cancer survivors. We describe the process developed at a free-standing NCI cancer center to meet the standard of SCP provision to all cancer patients. Methods: A multi-disciplinary subcommittee of the Cancer Committee was designated to develop the overall strategic plan for the implementation of this standard. It met with disease teams to facilitate a treatment summary from Cancer Registry data, identify patient reported symptoms using a self report tablet (SupportScreen). Electronic care plans were created using survivorship research program templates and ASCO framework for each disease site team. The disease team Nurse Care Coordinator inputs information into the eSCP. Results: Templates have been established within the EMR in the documents section under survivorship care plan title. These can be initiated and modified when the Nurse Care Coordinator chooses to start them. The disease teams have established their time points for SCP presentation to their patients. Using the cancer registry to provide data related to staging, treatments and genetic testing has helped minimize development time. Individual survivor’s concerns will be reflected in patient reports and physician symptom documentation. This eSCP completion process is a pilot program within the breast cancer disease team and will be expanded to include patients with head & neck and hematologic malignancies with a goal of including all patients by mid 2016. Conclusions: The goal of improving survivorship care coordination and compliance with surveillance guidelines is challenging. Maximizing available interdisciplinary resources has helped to create a viable Survivorship Care plan at our institution.