UNASSIGNED: 61 Background: @entity0 survivor numbers are increasing due to population aging and improved treatment outcomes but many of their long-term health care needs are unmet. Integrated follow-up care strategies that enhance care coordination, education, and access to survivorship resources are needed to provide @entity1 with evidence-based care that addresses medical and psychosocial needs after @entity5 treatment. METHODS: In 2008, we established the Johns Hopkins @entity0 Survivorship Program with representation from the Schools of Nursing, Public Health, and Medicine to address the needs of @entity1 completing initial @entity5 treatment and transitioning to long-term follow-up. @entity1 educational resources were created within an interactive website ( http://bit.ly/hZfzFi ) including > 35 @entity1 /provider educational video clips, blogs and social media. Activities including provider educational events, educational folders, and trainee curriculum additions have been ongoing. Starting May 2011, Hopkins @entity1 were offered a one-time transition visit with a nurse practitioner focusing on individualized treatment summary/survivorship care plan activities (e.g., @entity5 screening/surveillance, medical intervention, psychosocial support, and care coordination with non- @entity5 providers). RESULTS: Our website is averaging 3,000 hits monthly. We have participated in 22 provider/trainee formal educational presentations. In the pilot phase of these transition visits (n=40), age/race breakdown of @entity1 were representative of our @entity0 population (median age 51, range 34-69; 17% African Americans). Our post-visit survey (n=37), 97% found the survivorship visit beneficial and all reported that this one-time consultation helped with transitioning away from treatment. CONCLUSIONS: A multidisciplinary @entity1 -centered approach to @entity0 survivorship allowed us to develop comprehensive clinical and educational service models to benefit @entity1 and their @entity5 /non- @entity5 providers. This program aims to enhance education, overcome the fragmentation of the health care system, and improve overall health and wellness of @entity0 survivors as they transition to long-term survivorship.

Making it work: XXXX survivorship care at Johns Hopkins.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients', 'patient', 'Patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity0 :: ('MESH:D001943', 'Disease') :: ['Breast Cancer', 'Breast cancer', 'breast cancer']
@entity0 :: (MESH:D001943,Disease) :: ['Breast cancer']
