title: Survivorship programs and care plans in practice: variations on a theme.
abstract: OBJECTIVE
  THIS QUALITATIVE STUDY EXAMINED CANCER SURVIVORSHIP PROGRAMS AT FOUR HEALTH CARE ORGANIZATIONS IN LOS ANGELES COUNTY, CA: an academic medical center, a community hospital, a primary-care medical group, and a county hospital. The purpose was to describe the successful implementation of four distinctly different models of care, focusing on the creative development and use of the Institute of Medicine-recommended survivorship care plan (SCP) document in each setting.
  
  
  METHODS
  In-depth semistructured interviews were done with survivorship teams to characterize each program and the development and use of the SCP at each institution.
  
  
  RESULTS
  Each survivorship program has developed and implemented unique types of SCP documents. Specifically, a comprehensive SCP at the academic center, completed by the clinical team, which covers many facets of cancer survivorship; a patient-directed SCP at the community hospital, completed by the survivor with assistance of an oncology nurse and focused on treatment history and appropriate surveillance; an adapted ASCO SCP template at the primary-care medical group, completed via a partnership with contracted oncologists and focused on the treatment history, surveillance, and shared care between oncology and primary care; an adapted ASCO SCP template at the county hospital, completed by the survivorship nurse practitioner and focused on patient education, post-treatment care, and institutional care coordination.
  
  
  CONCLUSIONS
  The SCP document is a flexible tool that can be successfully adapted for use in extremely varied settings, from primary care to hospitals, to inform and educate patients and providers alike.
authors: Division of Cancer Prevention & Control Research and UCLA-LIVESTRONG Survivorship Center of Excellence, Jonsson Comprehensive Cancer Center at UCLA; UCLA Schools of Medicine & Public Health, Los Angeles, CA.
authors: Erin E
authors: EE
authors: Hahn
authors: Patricia A
authors: PA
authors: Ganz