Strategies for Successful Survivorship Care Plan Implementation: Results From a Qualitative Study
Strategies for Successful Survivorship Care Plan Implementation: Results From a Qualitative Study
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DOI：
10.1200/jop.17.00054
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发表时间：
2018-08-01
影响因子：
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通讯作者：
Jacobs, Sara R.
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文献类型：
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作者：
Birken, Sarah A.;Clary, Alecia S.;Jacobs, Sara R.
对美国癌症幸存者的护理往往是分散的，导致健康状况不佳。当幸存者和后续护理提供者收到幸存者护理计划（SCP），书面文件包含有关癌症诊断，治疗，监测计划和健康促进的信息时，护理和结果可能会得到改善。然而，实施SCP具有挑战性。因此，我们试图确定成功实施SCPs.Methods的战略：我们测量SCP实施使用的性能数据，从癌症计划参加美国临床肿瘤学会肿瘤学质量实践倡议，肿瘤学家主导的质量评估和改进计划。我们对癌症项目员工进行了半结构化采访（例如，医生）通过比较癌症项目中的方法，确定成功实施SCP的策略，根据质量肿瘤实践倡议绩效指标，制定并向相对较小比例的合格幸存者及其后续护理提供者提供SCP（即，低绩效者; 5个项目中的n = 6名参与者）结果：14个癌症项目中有10个为50%的合格幸存者制定了SCP; 14个项目中有2个为任何幸存者提供了SCP; 14个中有8个向25%的后续护理提供者提供了SCP。我们发现，中度表演者积极主动地解决SCP的要求，利用要求，以提高生存护理，设定内部目标，自动化实施，有积极的领导者和冠军，并与SCP implementation.Conclusion：SCP实施任务的适当员工仍然具有挑战性。我们确定了成功实施SCP的策略。未来的研究应该检查癌症项目是如何实现这些策略的;研究结果可能有助于理解实施全面生存护理所需的变化。
Introduction:Care for US cancer survivors is often fragmented, contributing to poor health outcomes. Care and outcomes may improve when survivors and follow-up care providers receive survivorship care plans (SCPs), written documents containing information regarding cancer diagnosis, treatment, surveillance plans, and health promotion. However, implementing SCPs is challenging. As such, we sought to identify strategies for successfully implementing SCPs.Methods:We measured SCP implementation using performance data from cancer programs participating in the American Society of Clinical Oncology Quality Oncology Practice Initiative, an oncologist-led quality assessment and improvement program. We used semistructured interviews with cancer program employees (eg, physicians) to identify strategies for successfully implementing SCPs by comparing approaches in cancer programs that, according to Quality Oncology Practice Initiative performance indicators, developed and delivered SCPs to a relatively small proportion of eligible survivors and their follow-up care providers (ie, low performers; n = 6 participants in five programs) with approaches among programs with better performance (ie, moderate performers; n = 15 participants in nine programs).Results:Ten of 14 cancer programs developed SCPs for 50% of eligible survivors; two of 14 delivered SCPs to any survivors; and eight of 14 delivered SCPs to 25% of follow-up care providers. We found that moderate performers proactively addressed SCP requirements, leveraged requirements to improve survivorship care, set internal targets, automated implementation, had active leaders and champions, and tasked appropriate employees with SCP implementation.Conclusion:SCP implementation remains challenging. We identified strategies for successfully implementing SCPs. Future research should examine how cancer programs have achieved these strategies; findings could contribute to an understanding of the changes needed to implement comprehensive survivorship care.