Survivorship Care Plans: Reaching a Benchmark and Striving to Achieve Intent.

Abstract

Survivorship care plans (SCPs) have been endorsed by major oncologic organizations despite challenges in implementation and unclear patient-specific benefits. In January 2020, the Commission on Cancer removed a 2018 provision that required accredited programs to deliver SCPs to eligible patients. Programs must determine whether to continue SCP use or begin de-implementation. We detail a framework to increase SCP delivery for programs continuing to provide SCPs as a component of survivorship care and suggest a patient-centered approach to evaluate continued utility amidst updated national standards. We surveyed medical, surgical, and radiation oncologists at our academic and community sites to identify barriers to SCP use and performed a Pareto analysis to highlight the most notable barriers. We then designed an intervention that used SCP templates within the medical record, disease-specific recommendations, delegation to nonphysician staff, and provider education. We monitored our intervention via a statistical process control analysis and assessed patient perceptions of SCP usefulness via a questionnaire. Before implementing our process improvements, our SCP completion rate during a 10-month period was 45%. During the 6-month period after our intervention, the SCP completion rate increased to 89%. Greater than 80% of patients who had recently received an SCP found the information helpful and were satisfied with the amount of information received. More than 40% did not remember receiving their original SCP. We demonstrated a feasible method for increasing SCP delivery for all cancers across a cancer network and used a patient-specific questionnaire to assess continued value amidst changing national standards.