are we engaging with survivorship care stakeholders or
TRANSCRIPT
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Katia Noyes, PhD, MPH
Professor of Surgery & Public Health Sciences
Scientific Director, SHORE
University of Rochester Medical Center
Are we engaging with survivorship care stakeholders or
staying married to our jobs?
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New York State Region
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Rural Medicine
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Reasons behind rural-urban disparity in cancer outcomes
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Appointment roaster for a new breast cancer patient
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[Lack of] Continuity of Care
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Home Meds NPO Surgery
Admit Med Rec
InpatientHome Meds
DischargeMed Rec
30-day Endpoint
Patient Hospital Journey
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Learning Objectives
1. Learn about the key stakeholder groups and their roles in cancer survivorship care.
2. Understand the key principles of stakeholder engagement and teamwork in cancer survivorship care.
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Model of Engagement
Community
Non‐MedicalFactors
HealthProviders
Survivorship Care
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Cancer Survivorship Care StakeholdersPhysicians (oncology specialists and PCPs)
Advance Practice Partners (NPs, social work, behavioral health, nursing)
Payers
Departments of Health & Social services
Community health organizations (vising and skilled nursing, pharmacy, transportation, CAM)
Community non-healthcare partners (social services, transportation, exercise, wigs and prosthetics)
Patients and caregivers
Patient navigators & advocates 14
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Principles of Stakeholder Engagement
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InterventionActivities:PatientChecklistBeforeIleavethecarefacility,thefollowingtaskshouldbecompleted:
IhavebeeninvolvedindecisionsaboutwhatwilltakeplaceafterIleavethe
facilityIunderstandwhereIamgoingafterIleave
thisfacilityandwhatwillhappentomeonceIarrive
IhavethenameandphonenumberofapersonIshouldcontactifaproblemarisesduring/aftermytransferanddischarge.
Iunderstandwhatmymedicationsare,howtoobtainthem,andhowtotakethem.
IunderstandthepotentialsideeffectsofmymedicationsandwhomtocallifI
experiencethem.
IunderstandwhatsymptomsIneedtowatchoutforandwhomtocallshouldI
noticethem.Iunderstandhowtokeepmyhealth
problemsfrombecomingworse.
Mydoctorornursehasansweredmymostimportantquestionspriortomyleaving
thefacility
MyfamilyorsomeoneclosetomeknowsthatIamcominghomeandwhatIwill
needonceIleavethefacility.
IfIamgoingdirectlyhome,Ihavescheduledafollow‐upappointmentwithmydoctor,andIhavetransportationto
thisappointment.
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Appointment roaster for a new breast cancer patient
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Taplin, S.H., et al., Teams and teamwork during a cancer diagnosis: interdependency within and between teams. J Oncol Pract, 2015. 11(3): p. 231-8.
“Teams are defined as two or more people who interact dynamically, interdependently, and adaptively to achieve a common, valued goal.”
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Models of Cancer Survivorship Care Delivery
http://www.asco.org/practice-research/models-long-term-follow-care
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http://www.cancernetwork.com/oncology-nursing/survivorship-care-essential-components-and-models-delivery/page/0/1
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Whyshouldyoucare?1. Improved communication between/among providers and cancer patients:
• less potential for errors,
• easier to f/u patients
• complete long-term data on costs, bundles, outcomes
2. Improves patient satisfaction scores:
• Reduce patient anxiety
• Reduce unnecessary travel and appointments
3. Improves outcomes
• Patient outcomes (satisfaction, fatigue, behavioral health, ADLs)
• Provider outcomes (number of patients seen, staff turn over, market share)
• Population health
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