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Erschienen in:

08.06.2016

Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care

verfasst von: Denalee O’Malley, Shawna V. Hudson, Larissa Nekhlyudov, Jenna Howard, Ellen Rubinstein, Heather S. Lee, Linda S. Overholser, Amy Shaw, Sarah Givens, Jay S. Burton, Eva Grunfeld, Carly Parry, Benjamin F. Crabtree

Erschienen in: Journal of Cancer Survivorship | Ausgabe 1/2017

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Abstract

Purpose

This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models.

Methods

Snowball sampling was used to identify innovators. Twelve participants (five cancer survivorship primary care innovators and seven content experts) attended a working conference focused on cancer survivorship population strategies and primary care transformation. Data included meeting discussion transcripts/field notes, transcribed in-depth innovator interviews, and innovators’ summaries of care models. We used a multistep immersion/crystallization analytic approach, guided by a primary care organizational change model.

Results

Innovative practice models included: (1) a consultative model in a primary care setting; (2) a primary care physician (PCP)-led, blended consultative/panel-based model in an oncology setting; (3) an oncology nurse navigator in a primary care practice; and (4) two subspecialty models where PCPs in a general medical practice dedicated part of their patient panel to cancer survivors. Implementation challenges included (1) lack of key stakeholder buy-in; (2) practice resources allocated to competing (non-survivorship) change efforts; and (3) competition with higher priority initiatives incentivized by payers.

Conclusions

Cancer survivorship delivery models are potentially feasible in primary care; however, significant barriers to widespread implementation exist. Implementation efforts would benefit from increasing the awareness and potential value-add of primary care-focused strategies to address survivors’ needs.

Implications for Cancer Survivors

Current models of primary care-based cancer survivorship care may not be sustainable. Innovative strategies to provide quality care to this growing population of survivors need to be developed and integrated into primary care settings.

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Titel: Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care
verfasst von: Denalee O’Malley
Shawna V. Hudson
Larissa Nekhlyudov
Jenna Howard
Ellen Rubinstein
Heather S. Lee
Linda S. Overholser
Amy Shaw
Sarah Givens
Jay S. Burton
Eva Grunfeld
Carly Parry
Benjamin F. Crabtree
Publikationsdatum: 08.06.2016
Verlag: Springer US
Erschienen in: Journal of Cancer Survivorship / Ausgabe 1/2017
Print ISSN: 1932-2259
Elektronische ISSN: 1932-2267
DOI: https://doi.org/10.1007/s11764-016-0555-2

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Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care