NP model of survivorship care: Lessons learned.

Abstract

26 Background: The number of cancer survivors is expected to reach 20 million by 2026. As patient volumes increase, oncologists are tasked with seeing more patients, often allowing less time for survivorship-related concerns. In an effort to address this issue, nurse practitioners (NPs) are equipped to aid survivors by managing late/long-term side effects of treatment, monitor for recurrence, provide survivorship care plan (SCP), and promote overall health and wellness. Methods: When initiating a survivorship program, our community cancer center utilized survivorship nurse practitioners (SNP) to address increasing patient volumes and patients’ survivorship issues. By beginning with breast cancer survivors, we were able to meet patients prospectively at diagnosis to provide support and introduce survivorship. SNP later saw patients in designated Survivorship Clinic, after completing treatment and in long-term survivorship to address physical/psychosocial concerns, place appropriate referrals, and promote overall wellness. Collaboration with local Primary Care Providers (PCP) was integral for the long-term care of survivors. Results: In 9 months, prospective data collection surveys helped to better understand patients’ needs, allocation of appropriate resources, and measure patient empowerment. Collaboration with EMR team helped address patient volumes and workflow. Future collaboration of survivors’ healthcare needs with PCP was done by routing 162 completed SCPs to patient-designated PCP and mailing over 185 survivorship program introduction letters to community PCPs. Conclusions: Meeting patients prospectively aided in promoting the importance of survivorship helped provide evaluation of our survivorship program’s growth and development. However, patients introduced to survivorship at diagnosis required a formal referral at the completion of treatment, which disrupted workflow. Collaborating with EMR team to develop survivorship referrals, survivorship clinic templates, and SCP reports were important. Continued work with PCPs will be integral to future success. NPs provide survivorship-focused care in the oncology setting, while meeting continued demands of a growing cancer survivorship patient population.