Abstract P3-08-16: Strengthening bridges: A navigation plan for survivors of breast and gynecological cancers in the Georgia Cancer Center for excellence at Grady Health
Authors: Senior-Crosby D , Thompson WW , Haardörfer R , Trim L 
Published: August 2014

Abstract
Background: By mandate, comprehensive cancer treatment facilities will have to provide continuum care services for the cancer survivors, such as, survivorship treatment care plans, patient navigation, and psychosocial distress screening by 2015. A dual survivorship patient navigation model was created at The Avon Foundation Comprehensive Breast Center at Grady Health System to include both lay patient navigator (PN) and a survivorship nurse practitioner (SNP). The Strengthening Bridges Survivorship Patient Navigation Program used this combination to provide cancer survivor education, medical follow-up, nutrition and social support services after completion of therapy. We believe formalizing support linkages through patient navigation has the potential to provide the patient with the full spectrum of holistic healthcare. Methods: A survivorship patient navigation program was implemented to assess patients’ support and barriers to continue healthcare; quality of life; understandability of late effects associated with treatment and use of a survivorship care plan. Enrollment into Strengthening Bridges included monthly educational support groups, scheduled appointments with SNPs to address post treatment side effects, pain management, lymph edema, and loss of range of motion, and depression; meetings with PNs for overall support. The survivors completed three assessments to generate a personalized survivorship care plan and to evaluate changes in late effects, emotional well being and socio-economic issues. Results: Twenty-one patients were enrolled in the Strengthening Bridges Program. Most of the patients were African American women (83.3%) that were approved for Medicaid or Medicare (64.7%). More than half of the enrollees (52.4%) reported the need to talk to others who have similar experiences with cancer and treatment. As a result 71.4% reported that they appreciated being part of a group of cancer survivors. Initially, patients’ survivor knowledge regarding late effects was low. However, at the midpoint, knowledge had increased for most participants, especially those who were very engaged in the program. Participants reported experiencing many late effects. While some acute effects such as surgical pain subsided over time, others such as; forgetfulness and fatigue were more static and concerns about appearance gained dominance. We learned that some participants utilized their survivorship care plans well, while others did not use it at all. Conclusions: Using the combined navigation model as a resource to support and guide patients’ post treatment has strong potential to increase the use of their generated individualized survivorship care plan, identify late effects of treatment, improve the use of their Primary Care Physician, and finally improve their quality of life. Patient navigation is one strategy to improve care for the underserved, uninsured, and underinsured cancer survivor. Providing supportive services to cancer survivors through patient and nurse practitioner navigation is an effective way to potentially reduce barriers that post treatment patients may face. This dual program also continually engages the patient in preventative maintenance of their healthcare.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-08-16.