There is an increasing focus on quality improvement regarding survivorship care services. Outcome measures should be built into the survivorship care program as it is developed, thus allowing the care delivery system to respond to areas demonstrating a need for improvement. Developing a Quality of Cancer Survivorship Care Framework: Implications for Clinical Care, Research, and Policy (Nekhlyudov et al, 2019) outlines fives areas for a cancer survivorship quality framework:
- prevention and surveillance for recurrences and new cancers
- surveillance and management of physical effects
- surveillance and management of psychosocial effects
- surveillance and management of chronic medical conditions
- health promotion and disease prevention
Furthermore, Evaluation of Effectiveness of Survivorship Programmes: How to Measure Success (Halpern & Argenbright, 2017) articulates the need to assess survivorship care beyond patient-reported outcomes and includes the following:
- assessments of program structure
- long-term outcomes (i.e., survival, quality-adjusted life-years, functional status)
- receipt of social support
- receipt of nutritional, rehabilitative, and fertility services
- program value (i.e., costs, resource utilization)
- increase access to needed survivorship care services
- health equity
Commission on Cancer (CoC) Standards
The American College of Surgeons Commission on Cancer (CoC) was established in 1922 as “a consortium of professional organizations dedicated to improving survival and quality of life for cancer patients through standard-setting, prevention, research, education, and the monitoring of comprehensive quality care.” The CoC establishes quality standards and accredits cancer programs based on those standards. Those standards and accredited programs are reviewed periodically to ensure the highest quality of care.
Since the inclusion of Survivorship Care into the Standards in 2015, there have been significant changes in how the Commission on Cancer has considered survivorship care (Blaes et al 2020). In the 2020 CoC accreditation standards, Optimal Resources for Cancer Care, Standard 4.8 calls for the establishment of a Survivorship Program under the guidance of the cancer committee. The appointed program coordinator and team will offer a slate of services such as treatment summaries, survivorship care plans, screening for recurrence and new cancers, rehabilitation services, support groups, psychological services, formalized referrals, or financial support services. This standard is intended to encompass all the survivorship care needs during and after treatment for the growing population of survivors.
Resources
Beyond Patient Satisfaction: Tips to Measure Program Impact. The National Cancer Survivorship Resource Center published a guide to monitor the success of survivorship programs.