Environmental scan gives insight
Environmental scan gives insight
Snapshot provides direction
To determine the state of survivorship across the United States and Canada, the Cancer Patient Education Network Survivorship Committee (CPEN) conducted an environmental scan in 2009 looking at the status of best practices at the institutions at which its members work.
At the time of its formation, the committee adopted the National Cancer Institute's definition of survivorship, which starts at the time of diagnosis and continues throughout the rest of a patient's life.
The Survivorship Committee clarified in their 2008 Tactical Plan, adding to the definition: "CPEN recognizes the important role of patient education intervention designed to educate, support, and empower survivors with their cancer experience through and beyond cancer. We believe that survivorship interventions should be guided by the principles of patient education and patient-centered care perspectives. The approaches may be clinical, formal, and informal, incorporating a whole person's perspective that addresses the physical, social, emotional, and spiritual needs of survivors and their caregivers."
The purpose of the environmental scan was to get some indication of where different organizations were in the process of recognizing, defining, or accepting best practices for survivorship care. For example, questions were designed to determine if cancer centers had adopted the Institute of Medicine's guidelines for survivorship care, if they followed other best practice guidelines, or none at all.
"This was a preliminary environmental scan. We were trying to get a broad sense of what is actually happening," explains Scott Secord, MSW, RSW, manager of the Clinical Survivorship Care Program at Princess Margaret Hospital in Toronto, Canada, and co-chair of the CPEN Survivorship Committee.
In the future, the information gained may be used to survey members on specific elements of survivorship care that indicates the need for further examination, he adds.
The survey was sent electronically to 237 individuals participating in the CPEN Network and 69 responded, or about 25%.
What did the environmental scan reveal?
About 50% of the respondents were familiar with the Institute of Medicine document on best practice for survivorship care. About 30% were unfamiliar or very unfamiliar. So, one-third of cancer centers were not aware of this guideline established for survivorship care, says Secord. About 20% reported their organization did not follow any guideline or best practice model.
Ninety-seven percent of the cancer centers are providing pamphlets and written materials. Education lecture style is being offered in 73% of the institutions, half use audio/visual tools, 47% use interactive workshops, and about 30% use electronic tools, such as Web casting, online information, or websites to aid in navigation.
"The primary method of intervention with patients is the provision of pamphlet materials and education sessions," says Secord.
Eighty-seven percent of those answering the survey are interested in building online supports. This is an area to develop further, as this type of technology is important to serve isolated cancer survivors and their communities, says Secord.
While the education department is often the deliverer of information materials, survivorship care is more often delivered by social workers (88%), followed by dietitians, nurses, patient educators, chaplains or others providing spiritual care, and volunteers.
Psychosocial support is the most prevalent intervention at 86%, followed by nutrition, patient education classes, palliative care, and side-effect management.
About 60% felt providers were attempting to assess survivorship needs. Forty percent did not have a standardized way to look at how to meet the needs of that patient population, according to survey results.
Thirty-three percent of institutions were able to provide patients with a survivorship care plan. About 25% provided a clinical care plan. Secord says it would be helpful to further explore this issue with the CPEN network to better define a survivorship care plan and what components it should cover, as well as whether the plan should be developed at the beginning of a diagnosis or at the completion of treatment.
A majority of those responding to the survey 75% said they were offering programs to address the late effects of cancer treatment. The top five areas of late-effects management were identified by the survey group to be psychosocial distress, fatigue, nutrition, pain management, and body image issues.
"Our conclusions are that it will be important to look at some of the findings from the survey to help us determine if we could identify some benchmarks to monitor the efforts of cancer centers to be able to provide survivorship interventions and even identify what needs to be considered a best practice model," says Secord.
Only about 10% of respondents reported they have distinctive programs for each population, such as breast cancer patients or prostate cancer patients.
In future surveys, it would be beneficial to determine which organizations are engaged in work that has a patient education/e-health strategy, he says.
"The electronic platform is an area to be further explored to determine the benefits of organizational collaboration," says Secord. "Few organizations can afford to build the elaborate platforms; there really needs to be more of a collaborative effort."
Source
Scott Secord, MSW, RSW, Manager, Clinical Survivorship Care Program, Princess Margaret Hospital, 610 University Ave., Toronto ON M5G 2M9, Canada. Telephone: (416) 946-4501 ext. 5724. E-mail: [email protected].
To determine the state of survivorship across the United States and Canada, the Cancer Patient Education Network Survivorship Committee (CPEN) conducted an environmental scan in 2009 looking at the status of best practices at the institutions at which its members work.Subscribe Now for Access
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