JL522. Optimizing Survivorship Care Plan Quality and Efficiency Through Cancer Registry Partnerships
Karen J. Hammelef, RN, DNP, Carevive Systems, Inc, Carrie Stricker, PhD, RN, Carevive Systems, Inc, Carrie Tilley, RN, MS, ANP, AOCNP®, Carevive Systems, Inc, Margaret A. O’Grady, RN, MSN, OCN®, Abington Memorial Hospital, Abington, Pennsylvania, Noel M. Arring, DNP, RN, OCN®, Mayo Clinic, Phoenix, Arizona, and Deborah A. Walker, RN, MSN, APRN®, Hartford Health Center, Hartford, Connecticut
© 2018 Harborside™
JADPRO Live at APSHO 2017
Marriott Marquis, Houston, Texas • November 2–5, 2017
The posters for the abstracts below can be found at:
Objective: Providing survivorship care plans (SCPs)to cancer patients was initially endorsed by the Institute of Medicine a decade ago as an essential component of quality care. Now mandated by accreditation and value-based payment programs, the process of care plan development and provision remains fraught with barriers, including mining of data necessary to generate a patient-specific treatment summary (TS) and care plan, and a mechanism for tailoring SCP content to individual clinical contexts. Electronic medical records (EMRs) facilitate the process but provide numerous limitations including lack of standardized data fields, inadequate tracking and reporting mechanisms, and sparse and disparate content, given the tremendous time and expertise needed to develop and maintain cancer-specific content. SCP software that is integrated with registry has shown promise to efficiently deliver a high volume of quality SCPs and allow clinicians to focus on patient care rather than manual creation.
Methods: Four diverse community and academic US cancer centers implemented SCP delivery utilizing cancer registry as the data source, interfaced by a commercially available rules-driven platform that ensures individualized, evidence-based care plan content for each patient. While all share this common platform, their processes for leveraging these capabilities and integrating the registry team into workflow vary widely and will be qualitatively described. Numbers of SCPs delivered and time spent in preparation will be described and compared pre and post registry-involvement with SCPs.
Results: Three of the 4 institutions have completed implementation and have been actively providing SCPs for between 3 and 24 months. Total SCP delivery/year reached 621 in one site, quadrupling rates from prior. Mean number of SCPs per month across established centers currently is 38 (range 21–101), time preparing SCPs was reduced to 5 to 20 minutes post registry-integrated processes from up to 2 hours at baseline. Variable workflow processes and roles for integrating registry staff will be described in the presentation.
Conclusions: Cancer registry data paired with an evidenced-based rules driven survivorship care planning software is an efficient solution to delivery of tailored and evidence based SCPs. Each of 4 centers have identified barriers and facilitators to this process that include degree and timing of registrar involvement, identified registrar champions and prior experience with cancer registry data. These and other barriers and facilitators to the process offer important implications for the advanced practice nurse seeking to implement this process.
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