Rose T

Background: Cancer survivors face unique posttreatment issues and require ongoing follow-up care. Per Commission on Cancer (CoC) and other cancer organizations, a survivorship care plan including a treatment summary and follow-up plan is standard of care. There are significant barriers to implementation of survivorship care plans due to the resources required. Our facility lacked a process to implement survivorship care plans. A need to expand clinical experiences for oncology fellows across the care continuum was also identified.

Methods: Researched existing private sector and VA models of providing cancer survivorship care. Analyzed literature regarding the unique care needs of veteran cancer survivors. NP led model was determined to support a holistic clinical care model including post treatment assessment, education, resources, and referrals.

Intervention: The Cancer Survivorship Clinic was implemented in August 2018, staffed by an oncology nurse practitioner and medical oncology fellows. Visits are face-to-face or by phone and one hour in length. Patients receive a survivorship care plan. The clinic provider addresses post-treatment health concerns and refers patients to other services when indicated. The clinic was created utilizing existing staffing and clinic space, no additional resources were needed.

Results: There were 30 Cancer Survivorship Clinic visits completed for veterans between 8/1/18 and 5/1/19. The clinic is part of an ongoing rotation for fellows and included in their annual orientation. Implementation of a Cancer Survivorship Clinic was effective in meeting the CoC Survivorship Care Plan standard. Oncology fellow rotation in the clinic has broadened their educational experience. Upon entering practice, fellows will be better equipped to address survivorship needs.

Discussion: The clinic was created utilizing existing medical oncology resources and staffing. Medical oncology is familiar with all cancer diagnoses and can therefore serve the entire cancer population. An NP-led model supports a holistic care approach, ensuring that physical and mental/emotional needs are addressed during the clinic visit. Oncology fellows receive an opportunity to care for patients following cancer treatment, expanding their understanding of cancer care. One drawback is the lack of fellow availability at certain times of the year.

Background: Cancer survivors face unique posttreatment issues and require ongoing follow-up care. Per Commission on Cancer (CoC) and other cancer organizations, a survivorship care plan including a treatment summary and follow-up plan is standard of care. There are significant barriers to implementation of survivorship care plans due to the resources required. Our facility lacked a process to implement survivorship care plans. A need to expand clinical experiences for oncology fellows across the care continuum was also identified.

Methods: Researched existing private sector and VA models of providing cancer survivorship care. Analyzed literature regarding the unique care needs of veteran cancer survivors. NP led model was determined to support a holistic clinical care model including post treatment assessment, education, resources, and referrals.

Intervention: The Cancer Survivorship Clinic was implemented in August 2018, staffed by an oncology nurse practitioner and medical oncology fellows. Visits are face-to-face or by phone and one hour in length. Patients receive a survivorship care plan. The clinic provider addresses post-treatment health concerns and refers patients to other services when indicated. The clinic was created utilizing existing staffing and clinic space, no additional resources were needed.

Results: There were 30 Cancer Survivorship Clinic visits completed for veterans between 8/1/18 and 5/1/19. The clinic is part of an ongoing rotation for fellows and included in their annual orientation. Implementation of a Cancer Survivorship Clinic was effective in meeting the CoC Survivorship Care Plan standard. Oncology fellow rotation in the clinic has broadened their educational experience. Upon entering practice, fellows will be better equipped to address survivorship needs.

Discussion: The clinic was created utilizing existing medical oncology resources and staffing. Medical oncology is familiar with all cancer diagnoses and can therefore serve the entire cancer population. An NP-led model supports a holistic care approach, ensuring that physical and mental/emotional needs are addressed during the clinic visit. Oncology fellows receive an opportunity to care for patients following cancer treatment, expanding their understanding of cancer care. One drawback is the lack of fellow availability at certain times of the year.

Background: Cancer survivors face unique posttreatment issues and require ongoing follow-up care. Per Commission on Cancer (CoC) and other cancer organizations, a survivorship care plan including a treatment summary and follow-up plan is standard of care. There are significant barriers to implementation of survivorship care plans due to the resources required. Our facility lacked a process to implement survivorship care plans. A need to expand clinical experiences for oncology fellows across the care continuum was also identified.

Methods: Researched existing private sector and VA models of providing cancer survivorship care. Analyzed literature regarding the unique care needs of veteran cancer survivors. NP led model was determined to support a holistic clinical care model including post treatment assessment, education, resources, and referrals.

Intervention: The Cancer Survivorship Clinic was implemented in August 2018, staffed by an oncology nurse practitioner and medical oncology fellows. Visits are face-to-face or by phone and one hour in length. Patients receive a survivorship care plan. The clinic provider addresses post-treatment health concerns and refers patients to other services when indicated. The clinic was created utilizing existing staffing and clinic space, no additional resources were needed.

Results: There were 30 Cancer Survivorship Clinic visits completed for veterans between 8/1/18 and 5/1/19. The clinic is part of an ongoing rotation for fellows and included in their annual orientation. Implementation of a Cancer Survivorship Clinic was effective in meeting the CoC Survivorship Care Plan standard. Oncology fellow rotation in the clinic has broadened their educational experience. Upon entering practice, fellows will be better equipped to address survivorship needs.

Discussion: The clinic was created utilizing existing medical oncology resources and staffing. Medical oncology is familiar with all cancer diagnoses and can therefore serve the entire cancer population. An NP-led model supports a holistic care approach, ensuring that physical and mental/emotional needs are addressed during the clinic visit. Oncology fellows receive an opportunity to care for patients following cancer treatment, expanding their understanding of cancer care. One drawback is the lack of fellow availability at certain times of the year.

Purpose: Describe a shared medical visit approach used to orient Veterans and their caregivers to a new cancer diagnosis and cancer care processes.

Background: Veterans are referred to the Cancer Care Navigation Team (CCNT) by a health care provider when they have suspicion of cancer or new cancer diagnosis, as there is no onsite oncologist. Veterans indicate high levels of distress in this initial phase due to lack of information, uncertainty of next steps, lack of support system and other psychosocial issues.

Methods: A Cancer Orientation Clinic using a shared medical visit was developed for Veterans and their caregivers. The objectives of the visit are to decrease distress, increase understanding of the cancer journey, increase coping and self-care skills, proactively identify barriers to care and improve coordination of care. Veterans with a high suspicion of cancer or new cancer diagnosis are consulted to CCNT and scheduled into the Cancer Orientation Clinic. Visits are face-to-face and one hour in length, Veterans attend the appointment as a group of 3-5. Veterans are encouraged to bring a caregiver to their appointment. The CCNT multidisciplinary team including a registered nurse, social worker and nurse practitioner facilitate the visit. Educational information and cancer resources are presented in a group format to encourage sharing and support. Participants are introduced to the role of the CCNT and what to expect when traveling to VA tertiary centers for cancer care. There is educational content and discussion about cancer, their fears, and how they can improve/maintain their health to enhance cancer treatment outcomes. Veterans are assessed for distress and potential barriers; advance directives and release of information forms are completed. Each participant is given an individualized care plan by the nurse practitioner. Evaluation forms are completed by participants at the end of the visit.

Results: There were 10 Cancer Orientation Clinic visits completed for Veterans within the Spokane catchment areas between 3/14/18 and 5/30/18, for a total of 38 Veterans. The average level of distress reported at the visit was 6 (on a 1-10 scale). Evaluation forms have shown Veteran and caregiver satisfaction with the visit content and presentation.

Purpose: Describe a shared medical visit approach used to orient Veterans and their caregivers to a new cancer diagnosis and cancer care processes.

Background: Veterans are referred to the Cancer Care Navigation Team (CCNT) by a health care provider when they have suspicion of cancer or new cancer diagnosis, as there is no onsite oncologist. Veterans indicate high levels of distress in this initial phase due to lack of information, uncertainty of next steps, lack of support system and other psychosocial issues.

Methods: A Cancer Orientation Clinic using a shared medical visit was developed for Veterans and their caregivers. The objectives of the visit are to decrease distress, increase understanding of the cancer journey, increase coping and self-care skills, proactively identify barriers to care and improve coordination of care. Veterans with a high suspicion of cancer or new cancer diagnosis are consulted to CCNT and scheduled into the Cancer Orientation Clinic. Visits are face-to-face and one hour in length, Veterans attend the appointment as a group of 3-5. Veterans are encouraged to bring a caregiver to their appointment. The CCNT multidisciplinary team including a registered nurse, social worker and nurse practitioner facilitate the visit. Educational information and cancer resources are presented in a group format to encourage sharing and support. Participants are introduced to the role of the CCNT and what to expect when traveling to VA tertiary centers for cancer care. There is educational content and discussion about cancer, their fears, and how they can improve/maintain their health to enhance cancer treatment outcomes. Veterans are assessed for distress and potential barriers; advance directives and release of information forms are completed. Each participant is given an individualized care plan by the nurse practitioner. Evaluation forms are completed by participants at the end of the visit.

Results: There were 10 Cancer Orientation Clinic visits completed for Veterans within the Spokane catchment areas between 3/14/18 and 5/30/18, for a total of 38 Veterans. The average level of distress reported at the visit was 6 (on a 1-10 scale). Evaluation forms have shown Veteran and caregiver satisfaction with the visit content and presentation.

Purpose: Describe a shared medical visit approach used to orient Veterans and their caregivers to a new cancer diagnosis and cancer care processes.

Background: Veterans are referred to the Cancer Care Navigation Team (CCNT) by a health care provider when they have suspicion of cancer or new cancer diagnosis, as there is no onsite oncologist. Veterans indicate high levels of distress in this initial phase due to lack of information, uncertainty of next steps, lack of support system and other psychosocial issues.

Methods: A Cancer Orientation Clinic using a shared medical visit was developed for Veterans and their caregivers. The objectives of the visit are to decrease distress, increase understanding of the cancer journey, increase coping and self-care skills, proactively identify barriers to care and improve coordination of care. Veterans with a high suspicion of cancer or new cancer diagnosis are consulted to CCNT and scheduled into the Cancer Orientation Clinic. Visits are face-to-face and one hour in length, Veterans attend the appointment as a group of 3-5. Veterans are encouraged to bring a caregiver to their appointment. The CCNT multidisciplinary team including a registered nurse, social worker and nurse practitioner facilitate the visit. Educational information and cancer resources are presented in a group format to encourage sharing and support. Participants are introduced to the role of the CCNT and what to expect when traveling to VA tertiary centers for cancer care. There is educational content and discussion about cancer, their fears, and how they can improve/maintain their health to enhance cancer treatment outcomes. Veterans are assessed for distress and potential barriers; advance directives and release of information forms are completed. Each participant is given an individualized care plan by the nurse practitioner. Evaluation forms are completed by participants at the end of the visit.

Results: There were 10 Cancer Orientation Clinic visits completed for Veterans within the Spokane catchment areas between 3/14/18 and 5/30/18, for a total of 38 Veterans. The average level of distress reported at the visit was 6 (on a 1-10 scale). Evaluation forms have shown Veteran and caregiver satisfaction with the visit content and presentation.