Birken Sarah A, Raskin Sarah, Zhang Yuqing, Lane Gema, Zizzi Alexandra, Pratt-Chapman Mandi
Department of Health Policy and Management, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 1103E McGavran-Greenberg, 135 Dauer Drive, Campus Box 7411, Chapel Hill, NC, 27599-7411, USA.
L. Douglas Wilder School of Government and Public Affairs, Virginia Commonwealth University, Richmond, VA, USA.
J Cancer Educ. 2019 Jun;34(3):614-622. doi: 10.1007/s13187-018-1374-0.
Survivorship care plans (SCPs)-documents intended to improve care for cancer survivors who have completed active treatment-are required, yet implementation is poor. We sought to understand SCP implementation in cancer programs in the USA with the objective of identifying opportunities for improvement. We recruited cancer care providers in the USA via several cancer care networks to participate in a survey regarding SCP implementation. We used descriptive statistics to analyze the data. Three hundred ninety-five providers from diverse cancer programs in 47 states and Washington, DC responded to the survey. The timing of SCP implementation varied across and within cancer programs, with approximately 40% of respondents reporting developing SCPs more than 3 months after primary treatment or adjuvant therapy completion. Nurse navigators were responsible for 48-58% of each stage of SCP implementation. Processes that could have been automated often occurred in-person or via phone and vice versa. Respondents reported spending more than 2 h per SCP to complete all stages of implementation, of which less than a third was reimbursed by third-party payers. We identified several opportunities for improving SCP implementation, including broadening the base of responsibility, optimizing modes of communication, decreasing the time required and increasing the funding available, and limiting variation in SCP implementation across and within cancer programs. Future work should assess the influence of approaches to SCP implementation on desired outcomes.
生存护理计划（SCPs）——旨在改善已完成积极治疗的癌症幸存者护理的文件——是必需的，但实施情况不佳。我们试图了解美国癌症项目中SCP的实施情况，目的是找出改进的机会。我们通过几个癌症护理网络招募了美国的癌症护理提供者，以参与一项关于SCP实施的调查。我们使用描述性统计分析数据。来自47个州和华盛顿特区不同癌症项目的395名提供者对调查做出了回应。SCP实施的时间在不同癌症项目之间以及项目内部各不相同，约40%的受访者报告称在主要治疗或辅助治疗完成后3个多月才制定SCP。护士导航员负责SCP实施各阶段的48%至58%。本可自动化的流程往往通过面对面或电话进行，反之亦然。受访者报告称，每个SCP实施的所有阶段花费超过2小时，其中不到三分之一由第三方支付者报销。我们确定了几个改进SCP实施的机会，包括扩大责任基础、优化沟通方式、减少所需时间、增加可用资金，以及限制癌症项目之间和项目内部SCP实施的差异。未来的工作应评估SCP实施方法对预期结果的影响。
