Program Improves Transitioning Young Cancer Survivors to Adult Survivorship Care
A program improves the transition from pediatric to adult survivorship care has had a 100% increase in referrals.
ORLANDO, FL—A program created by Seattle Children's Hospital and the Seattle Cancer Care Alliance to improve the transition from pediatric to adult survivorship care has had a 100% increase in referrals, according to results presented at the ONS 40th Annual Congress.
“The Childhood Cancer Survivor Study has made tremendous contributions to our understanding of physical and psychosocial late effects of cancer treatment,” said Debra Loacker, RN, BSN, of Fred Hutchinson Cancer Research Center, Seattle, Washington.
In the study, long-term follow-up of 20,346 young adults who had a cancer diagnosis between 1970 and 1986 and 40,000 sibling controls showed that 70% of childhood cancer survivors have at least one chronic condition, and 32% have at least one severe or life threatening condition.
“Results strongly indicate the need to provide survivorship-focused clinical care to survivors of pediatric cancer as they transition into adulthood,” said Debra Loacker, RN, BSN, of Fred Hutchinson Cancer Research Center, Seattle, Washington.
In 2013, the APRN-led survivorship programs at the Seattle Cancer Care Alliance and Seattle Children's Hospital convened to evaluate and improve the process for transitioning young adult survivors of cancer to the adult survivorship program.
Three goals were underscored: improved communication between providers in both programs, coordination of care for cancer survivors, and improved education on the benefits of survivorship care across the age span.
Regular meetings resulted in a formalized process for referrals being identified and implemented. The team created a database to track referrals, appointment completion, and general patient demographics.
In addition, a 10-item questionnaire for the patient and/or parent was developed to assess a patient's readiness for transition to adult survivorship care.
The transition begins at age 14 years with a goal of completion at 21 years. From January 2010 through September 2014, 49 patients were referred from the Survivor Clinic at Seattle Children's Hospital to the Survivorship Clinic at the Seattle Cancer Care Alliance. Of these referrals, 69% occurred after the intervention was implemented.
Patients were 17 to 29 years of age and 49% were male. Diagnoses included leukemia (51%), lymphoma (14%), brain tumors (14%), sarcoma (10%), and other (10%).
“We are encouraged by a 100% increase in referrals since implementing this program, and will continue to monitor the appointment completion rate,” Loacker said.
“A secondary gain has been the formation of a robust, multidisciplinary and multi-institutional committee focusing on the needs of young adult survivors.
Success of the intervention will be measured by completion of Seattle Cancer Care Alliance appointments. The majority of patients (N = 34) referred after the intervention implementation are due for visits beginning in September 2014.
Patients first appointment is 1 year after their last Seattle Children's Hospital appointment. All tools are in effect as of April 2015. Ongoing tracking will compare appointment completion rate to the 50% baseline completion rate.