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Implementation is the execution of the nursing care plan developed during the planning phase.
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Related Experiment Video

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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
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Using Quality Improvement Methodology to Implement Survivorship Care Plans.

Christine Moore Smith1, Debra L Friedman1, Barron L Patterson1

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Pediatric oncology clinics can improve timely survivorship care plan (SCP) delivery using quality improvement methods. This initiative successfully increased SCP provision, meeting accreditation standards for cancer centers.

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Area of Science:

  • Oncology
  • Healthcare Quality Improvement
  • Cancer Survivorship

Background:

  • Accreditation by the American College of Surgeons' Commission on Cancer mandates survivorship care plans (SCPs) for patients receiving curative cancer treatment.
  • Traditionally, pediatric oncology patients received SCPs later in survivorship care, often in dedicated clinics.
  • The need for timely SCP provision in acute care settings was identified.

Purpose of the Study:

  • To implement a process for timely creation and delivery of SCPs to eligible pediatric oncology patients.
  • To improve the provision of SCPs within the acute care pediatric oncology clinic setting.
  • To establish a bridge to long-term survivorship care.

Main Methods:

  • Quality improvement methodology was employed to develop and implement the SCP process.
  • Eligible patients were identified based on curative treatment intent using cancer registry data.
  • Process monitoring utilized P charts for SCP creation and run charts for completion rates.

Main Results:

  • The percentage of eligible patients with an SCP increased from 28% to 53% within six months of intervention.
  • Continued improvements led to a 69% SCP completion rate by June 2019.
  • The intervention demonstrated a significant increase in timely SCP provision.

Conclusions:

  • Quality improvement initiatives enabled a pediatric oncology clinic to modify clinical practice for earlier SCP delivery.
  • A sustainable process for survivorship planning was successfully implemented, meeting accreditation requirements.
  • The study highlights the effectiveness of QI in enhancing cancer survivorship care delivery.