Patient Satisfaction and Participation in Integrated Survivorship Visit vs Extended Consultative Survivorship Visit for Curative-Intent Breast Cancer Patients

November 2018 Vol 9, NO 11
Carol Del Campo, RN, BSN, OCN
Northside Hospital/Atlanta Cancer Care
Kevin Schreffler, MSN, RN, OCN
Northside Hospital/Atlanta Cancer Care
Dawn Hayes, PT, PhD, GCS
Northside Hospital/Atlanta Cancer Care
Donna Meyer, BSN, MS
Northside Hospital/Atlanta Cancer Care
Bryan Miller, MSW, LCSW, OSW-C
Northside Hospital/Atlanta Cancer Care
Amy Sickles, PA-C
Northside Hospital/Atlanta Cancer Care
Mildred Nunez Jones, BA, CTR
Northside Hospital/Atlanta Cancer Care
Hiba Tamim, MD
Northside Hospital/Atlanta Cancer Care

Background: The Academy of Oncology Nurse & Patient Navigators (AONN+) promotes the goal to share best practices for survivorship and to address the question “Does the Survivorship Care Plan (SCP) meet patient goals?” (Staci Oertle, RN, MSN, APN, AOCNP, AONN+ Survivorship Committee). Programs accredited by the Commission on Cancer and the National Accreditation Program for Breast Centers are expected to meet or exceed the delivery of SCPs to 50% of eligible patients by the end of 2018. However, the best method of delivery to provide this information to the patient is yet to be defined; it remains unclear whether SCPs improve patient outcomes (Perry et al, 2013). A pilot study completed at Atlanta Cancer Care/Northside Hospital Cancer Institute demonstrated that an Extended Consultative Survivorship Visit (ECSV) improved patient confidence in managing disease, but the benefit did not justify the increased program cost and resource utilization over an Integrated Survivorship Visit (ISV). After these findings, the program moved to an ISV model.

Objective: A new study has been initiated to address the need for further information to determine best practices for SCP delivery. This study will compare the patient satisfaction and self-efficacy results of the new ISV process with the previous ECSV study. The study will measure self-reported confidence in managing physical and emotional outcomes of cancer treatment on quality of life and patient satisfaction. The secondary aim is to evaluate the number of patients who are provided with an SCP in an ISV in comparison with the number of patients who participated in the ECSV.

Methods: Quasi-experimental post survey design was used in the pilot study of curative-intent breast cancer patients who self-selected into an ECSV; a visit by AP included symptom review, discussion about current issues, SCP review, and support service referral. Posttesting was conducted by mailed survey, including self-efficacy survey, tracking of referral activity, and patient satisfaction. The new ISV imbeds the delivery and review of SCP into the 3-month follow-up visit with a physician or AP. The same mailed post visit survey will be sent to curative-intent breast cancer patients who have participated in ISV. Secondary data will be collected on the percentage of visits provided by ECSV versus ISV.

Results: In the pilot study, 73 patients were eligible for ECSV; 34 patients completed the visit, including pre- and posttest. Eighty-nine percent of patients who completed ECSV felt their understanding improved, 66% found the SCP helpful, 59% reported it prepared them for transition, and 77% were satisfied with the service; 7% demonstrated a positive change in pre- and posttesting assessment. Time study data revealed that overall time spent per patient was 3.7 hours in the new ISV model, which resulted in a 65% reduction in time spent per patient (1.25 hours).

Conclusion: New survey data will be compared with the pilot study results and reported. In addition, the number of eligible patients and completed SCP deliveries by ISV will be measured and reported.

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Last modified: November 15, 2018

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