Pilot testing a strategy to facilitate dissemination of quality standards aimed at improving continuity of cancer care

Background: Cancer patients face physical, emotional and practical barriers to care. Inability to cope with these challenges can reduce the likelihood of optimal treatment. Thus, the Commission on Cancer (CoC) introduced three quality indicators to improve continuity of care. Effective 01/2015, cancer centers must offer patient navigation, distress screening and survivorship care planning services to maintain CoC accreditation. 

Methods: We tested a strategy to disseminate the new standards, hosting two evidence academies (EA) for South Carolina CoC-accredited centers. The initial two-day meeting consisted of presentations by national and state experts on: a) evidence-based models, b) cancer center implementation experiences, c) toolkits/templates, and d) workgroup planning sessions. A second one-day meeting 9-months later focused on sharing best practices and lessons learned during implementation.  

Results: For the first EA, 57 participants attended, representing 19 of 21 centers. N=45 participants attended the second EA. At the initial meeting, half of participants reported high readiness (9 or 10 on 10-point scale) to meet the navigation standard, with fewer reporting readiness to meet distress screening (39%) and survivorship care planning (25%) standards. Top barriers to implementation related to information technology (68%), staffing (63%), and funding (61%) challenges, difficulty reaching patients (55%) and cost to patients (47%). Participant satisfaction was high, with 84% rating overall EA quality as excellent.

Discussion: The EA strategy was feasible to implement and enabled rapid sharing of best practices across the majority of state centers. Results suggest implementation of survivorship care planning will be most challenging of the three services.