St Luke's Mountain States Tumor Institute, Boise, ID.
J Oncol Pract. 2014 Mar;10(2):e81-5. doi: 10.1200/JOP.2013.000945. Epub 2013 Sep 24.
The 2015 Commission on Cancer standards require that cancer survivors receive an individualized survivorship care plan (SCP). To meet this new standard, St Luke's Mountain States Tumor Institute (MSTI), with support from the National Community Cancer Centers Program, implemented a successful survivorship model.
At MSTI, the patient's SCP is prepared in the electronic health record by a registered health information technician. This document is reviewed during an appointment with a nurse practitioner and social worker. The provider's dictation is mailed to the primary care physician with the SCP. From August 2011 to Oct 2012, 118 patients with breast cancer were seen for survivorship appointments. Medical record audit and follow-up telephone call were completed to evaluate patient survivorship needs and satisfaction with the appointment. Patient accounts were reviewed for reimbursement.
From medical record review, the most common patient concerns were weight management (35%), fatigue (30%), sexuality (27%), anxiety (23%), caregiver stress (17%), and depression (16%). Telephone calls showed high patient satisfaction and understanding. Patients rated the following statements on a Likert scale from 1 (strongly disagree) to 5 (strongly agree): I understand my treatment summary and care plan (88% strongly agree or agree), and I feel the survivorship visit met my survivorship needs (86% strongly agree or agree). At 1 month, 80% of participants were still working on wellness goals. Patient accounts analysis showed revenue covered costs.
Survivorship care at MSTI meets new standards, allows for patient engagement and satisfaction, and improves care coordination. Costs are covered by reimbursement.
2015 年癌症委员会标准要求癌症幸存者制定个体化的生存护理计划（SCP）。为了满足这一新标准，在国家社区癌症中心项目的支持下，圣卢克山脉州肿瘤研究所（MSTI）实施了成功的生存模式。
在 MSTI，患者的 SCP 由注册健康信息技术人员在电子健康记录中准备。该文件在与执业护士和社会工作者预约时进行审查。提供者的口述被寄给初级保健医生，同时附上 SCP。从 2011 年 8 月到 2012 年 10 月，有 118 名乳腺癌患者接受了生存预约。进行了病历审核和随访电话以评估患者的生存需求和对预约的满意度。审查了患者的账户以进行报销。
从病历审查中，患者最常见的问题是体重管理（35%）、疲劳（30%）、性行为（27%）、焦虑（23%）、照顾者压力（17%）和抑郁（16%）。电话调查显示患者满意度和理解度很高。患者在李克特量表上对以下陈述进行评分，从 1（强烈不同意）到 5（强烈同意）：我理解我的治疗总结和护理计划（88%强烈同意或同意），我觉得生存访问满足了我的生存需求（86%强烈同意或同意）。在 1 个月时，80%的参与者仍在努力实现健康目标。患者账户分析显示收入覆盖了成本。
MSTI 的生存护理符合新标准，允许患者参与和满意，并改善了护理协调。成本通过报销得到覆盖。
