San Francisco, CA—A collaborative program between Memorial Sloan Kettering Cancer Center in New York, NY, and the City of Hope in Duarte, CA, has helped educate nurses about survivorship care and facilitate their development at their own institutions. Funded by a grant from the National Cancer Institute (NCI), the program focused on setting and evaluating goals pertaining to comprehensive survivorship care.
“While participants from our first 2 courses represented a variety of academic and community settings, their goals were quite similar and reflected the basic need for staff education and plans for clinical services,” said Mary McCabe, RN, MA, Director of the Cancer Survivorship Initiative at Memorial Sloan Kettering Cancer Center. “Our data demonstrate that survivorship remains in the early stages as a formal period of care, and ongoing development of experts and resources continues to be needed.”
As Ms McCabe reported at the 2016 Cancer Survivorship Symposium, the Institute of Medicine report on cancer survivorship, released in November 2005, calls for the education of health professionals, yet few formal programs have been instituted and evaluated.
The NCI grant provided travel and lodging for 113 nurses, who had received recommendation and support from the leadership of their practice.
“Nurses came from a variety of practice settings,” said Ms McCabe, “including academic hospitals, community cancer centers, NCI-designated facilities, physician’s offices, and VA hospitals.”
According to Ms McCabe, the program included didactic and interactive sessions as well as goal development, which focused on survivorship activities to be implemented at the nurses’ home institution or practice.
A total of 403 goals were coded for the first 2 courses. The most frequent goal for both courses was “professional education” (23.1%, 21%) followed by “institution of survivorship care” (13%, 9.5%). “Evaluation of survivor needs” and “team development” were the third most frequent goals for Course 1 and 2, respectively.
Specific goals included the following:
- Educate cancer care center employees, at in-services held during staff meetings, about the survivorship program initiative and key components of the program within the next 18 months
- Create a mechanism to identify patients who have completed adjuvant breast, colon, or lung treatment each month at each site
- Conduct survivor needs assessments and evaluations of the survivorship clinic by participants
- Recruit key employees to form a multidisciplinary committee to meet monthly to develop a strategic survivorship program plan, including a mission statement and program guidelines within the next year.
For Course 1, 70% of goals were reported “completed” or “in process” with only 4.4% of goals being “stalled” or “stopped.” Twenty-five percent of goals, however, were coded “never started.” For Course 2, 62% were completed or in process, 18.3% stalled or stopped, and 20% never started.
Ms McCabe also noted a change in status of attendees over time—from being predominantly nurses to nurse practitioners.
“As attendees began to develop programs,” she said, “the people who needed to learn and be educated evolved too, as well as the sophistication of what they wanted to achieve.”
Barriers to success were met by approximately 29% of the participants in Course 1 and approximately 38% in Course 2. Identification of barriers and facilitators to address them will be critical in the future, she observed.
Despite these barriers, Ms McCabe expressed satisfaction with the program’s success, which is now in the analysis stage of the grant.
“It was a pleasure to watch the program evolve,” she said. “It definitely changed in terms of its sophistication and goal setting.”
“There are actually people here [at the Survivorship Symposium] who took the course,” she concluded, “so, at least in part, it says that we’ve created a community.”
McCabe M, Economou D, Grant M. Preparation of nurses for cancer survivorship care. Presented at: Cancer Survivorship Symposium; January 15-16, 2016; San Francisco, CA. Abstract 27.