Using Quality Improvement Methodology to Implement Survivorship Care Plans.

Abstract

PURPOSE Accreditation requirements for cancer centers by the American College of Surgeons' Commission on Cancer have included provision of survivorship care plans (SCPs) to patients treated with curative intent soon after completion of therapy. These were traditionally provided in a dedicated survivorship clinic for our pediatric oncology patients later in the survivorship time period. Our goal was to increase timely provision of SCPs to eligible patients in our acute care pediatric oncology clinic and to have this serve as a bridge to longer-term survivorship care. METHODS Our pediatric oncology clinic used quality improvement methodology to implement a process for creation of SCPs. We defined eligible patients on the basis of curative intent. Cancer registry data were queried to find eligible patients, and chart reviews were done weekly. A P chart and run chart were used to monitor our process for creation of plans and overall completion rate, respectively. RESULTS During the intervention period, we increased the percentage of eligible patients with an SCP from 28% on June 30, 2017, to 53% by December 31, 2017. Since that time, we have continued to increase the percentage of patients with SCPs, reaching 69% by June 30, 2019. CONCLUSION By using quality improvement methodology, our pediatric oncology clinic was able to change its clinical practice and implement a sustainable process for provision of SCPs and survivorship planning earlier in the post-treatment course, and meet the Commission on Cancer accreditation standard.