Implementation of a survivorship clinic in a medically underserved comprehensive community cancer center.

Abstract

54 Background: Historically, preparation of Survivorship Care Plans (SCPs) had been a cumbersome challenge that resulted in a limited number of plans delivered to eligible patients. In 2015, eleven breast SCPs were prepared and delivered by an RN. Upon review, it was determined the process of preparation and delivery of SCPs required refinement. Methods: Initially, we identified the barriers to our practice, which included limited knowledge, process, personnel, and software interfacing. We implemented a quality improvement project with the goal of delivery of SCPs to an increased number of cancer survivor patients. The project targeted staff education to identify eligible patient populations, create awareness of the Commission on Cancer accreditation requirements, and the knowledge necessary to create a SCP. We coordinated with the information technology department to attempt interfacing software programs, track the delivery of plans, and use provider notes to export data. We increased communication between departments to identify eligible patient populations. A nurse practitioner was assigned the responsibility for preparation and delivery of the document during a scheduled appointment, which focused on review and education in relation to the patient’s diagnosis, treatment plan, sequelae and recommended surveillance. Results: Through close coordination of interdisciplinary teams, we were able to implement strategies to develop a streamlined process to create and deliver SCPs. These interventions resulted in the Survivorship Clinic going from 11 breast cancer SCPs delivered in 2015 to 98 and counting, of all types of cancer, delivered in 2016. Patients requested follow up visits to the Survivorship clinic. Conclusions: We have successfully developed a Survivorship Clinic within a federally designated medically underserved community setting. Implementation of best practices resulted in nine-fold increase in delivery of SCPs. Most importantly, we have increased patient education and satisfaction. Our practices can be replicated by other programs and thereby curb the disparity of cancer survivorship care in rural areas.