Implementation and Evaluation of an Expanded Survivorship Program

October 2016 Vol 7, No 9


Eileen Brennan-O'Neill, RN, BA, OCN
Northwell Health Cancer Institute, Monter Cancer Center, Lake Success, NY
Karen Gleason, RN, BSN, OCN
Northwell Health Cancer Institute, Monter Cancer Center, Lake Success, NY
Sara Parise, RN, BSN, OCN, CN-BN
Northwell Health Cancer Institute, Monter Cancer Center, Lake Success, NY

Background: The Northwell Health Cancer Institute consists of 12 disease site Centers of Excellence, one being the Breast Cancer Center of Excellence. Under this scope, the survivorship program for breast cancer was launched in 2012. A survivorship care plan (SCP) is the record of a patient’s cancer history and recommendations for follow-up care. Both the Commission on Cancer (CoC) and the National Accreditation Program for Breast Centers (NAPBC) have implemented SCPs in their standards. The Northwell Health Cancer Institute implemented the SCP program in 2012; however, based on the current CoC and NAPBC standards, a new process was needed to comply.

Objectives: To evaluate the effectiveness of a newly expanded SCP program.

Methods: The Northwell Health Cancer Institute recently implemented a complete electronic medical record (EMR) that allows multiple practitioners to document in the same chart, allowing for transparency and increased communication among providers. The breast cancer nurse navigator formed a task force to determine how the old SCP process could be implemented into this new EMR. Those invited to be a part of the task force were registered nurses (RNs) and nurse practitioners (NPs) who were a part of the original implementation in 2012 and some new members to allow for a new perspective. First, the task force had to decide which SCP to utilize best in the EMR. The process included reviewing multiple templates; a standard operating procedure was formulated; including the background of why the SCP was necessary; the disease sites that would be eligible; and instructions on how to complete the SCP. Barriers to this were determining the exact diseases and stages to be included. As stated in the CoC Standard, the SCP is focused on the subset of survivors who are treated with curative intent and have completed active therapy. The task force went through each disease site and specifically laid out who would be eligible for the SCP and when. Starting January 1, 2016, any patient who was determined eligible was to be given an SCP under this plan.

Results: The new process for the SCP was completed by the task force in about a year. A tracking system was also utilized that allowed the RNs and NPs completing the SCP to enter patient’s data to ensure timeliness of the SCP delivery. The RN and NP enter the patient’s information into the tracking form at the beginning of the treatment. From there, the NP and RN complete the form in the EMR at the end of the patient’s treatment and then deliver it to the patient at a visit within 3 months of the completion of treatment. For the first quarter of 2016, 86 patients were delivered an SCP. The CoC Standard states that 25% of eligible patients should receive an SCP by the end of 2016. The Northwell Health Cancer Institute was reviewed by the CoC in June 2016, and the Standard was met.

Conclusions: So far, the program has been deemed effective based on the number of patients who received an SCP and the fact that the CoC Standard was met for this survey. Ongoing research will determine the feasibility of expansion to other departments under the Cancer Institute.

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Last modified: August 10, 2023

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