Cancer Survivorship: A Look at Current Practices and Resources for OTs Stephanie Phan, Hon BSc(OT), OTReg. (Ont.) June 16, 2011 Professional Issues Forum CAOT Conference, Saskatoon
Objectives Evolution of OT role in Cancer Survivorship Current OT Practice Education & Training Resources Survivorship Program at Princess Margaret Hospital
Getting a Foot in the Door Advocacy, Advocacy, Advocacy Writing a Proposal for funding of OT role in Breast Cancer Survivorship Pilot of OT role in clinics Permanent OT position
Starting from Scratch Pioneering Role of OT in Survivorship Uncharted Grounds Thinking Outside the Box Environmental Scan Use of Logic Model to develop clinics
Current OT Roles in Survivorship: Clinician & Navigator Advocate Program developer Patient Education resource developer Information systems supporter Educator Researcher Lecturer Presenter Social Network Moderator Complementary Therapist
Education & Training Essential Content of Survivorship Training for Health Care Providers Prevention of secondary cancers General discussion of survivorship Long-term complications/sequelae of treatment Trends and statistics in health care access Health care systems/quality assurance/models of care Rehabilitation services Quality-of-life issues in survivorship Detection of recurrent and secondary cancers Pain management Palliative care/end-of-life care Short-term complications Treatment of recurrent cancer SOURCE: Ferrell et al. (2003).
Components of Care Survivorship care should include: Prevention and detection of new and recurrent cancers and side effects of treatment Ensuring access to effective interventions Focus on healthy behaviors to improve survivors health and quality of life Survivors taking responsibility for their care guided by an organized plan
Barriers to Optimal Survivorship Care Fragmented delivery system Poor coordination of services Absence of a locus of responsibility Lack of survivorship standards of care Difficulties in communication The capacity for delivering survivorship care Lack of guidance on how survivors can maximize their own health outcomes
Training & Education Resources Comprehensive clinical practice guidelines Late and persistent effects of cancer and its treatment Canadian Cancer Society American Society of Clinical Oncology National Comprehensive Cancer Network National Guidelines Clearinghouse database Journal review articles European Journal of Cancer Care: FACET
STAR Program & STAR Clinician Certifications Provide optimal clinical care, promote outcomes studies and clinical research on-line self-paced educational modules evidence-based training in cancer rehab
Other Sources of Information Canadian Oncology Website created by OTs for OTs From Cancer Patient to Cancer Survivor: Lost in Transition Cancer Survivorship: Cancer Transitions Canadian Partnership Against Cancer Canadian Association of Psychosocial Oncology LiveStrong Wellspring BCCA, Cancer Rehabilitation, Vancouver Hope & Cope, Montreal
Complexity POPC PMH Survivorship Program TRI/WCH Level two Self Care Program Lymphedema Function&Mobility Fatigue Attention&Memory Bone health Survivorship Consultation Know Navigate Negotiate Self Management Program Information Education classes Tools Support Your diagnosis Your treatment Your treatment team To find supports in the hospital To find the supports in your community For your care during treatment For your care following treatment Level one Diagnosis Treatment Survivorship Time
Goals of the Survivorship Program Engage and empower survivors to self-manage their health with appropriate support Reallocate health care human resources through changing scopes of practice Apply e-health technologies to engage survivors by providing information and support at point of need Organize patient and population data to facilitate education, survivorship research and efficient and effective survivorship care
Survivorship Self-care Clinics Survivorship Self-Care Programs Lymphedema Clinic Healthy Lifestyle Programs Healthy Steps Fatigue Clinic Neurocognitive Clinic Taking Charge Function &Mobility Clinic Healthy Eating Healthy Bones Program
Interdisciplinary Team PFC RN PT OT 3 MLD Therapists Dietician Social Workers Psychologists Volunteers
Supports PMH AH and PtEd staff Informatics team ELLICSR research team Clinicians moderating sessions on CaringVoices Community cancer centres
A Need for Innovation The Problem: How to respond to unmet need for psychosocial support? A Response: Virtual Communities = social networks formed or facilitated through electronic media The power of peer to peer support Looking for normalization Learning from other s experiences
Innovation: Patient Portal Breast Cancer, Diabetes &Chronic Kidney Disease 22 lab test results/imaging/path Treatment protocols/summaries Clinical care guidelines Scheduling (read only) Brochures and Pamphlets/Calendar of events Ask a librarian Connect to support groups Chronic Disease Management Tools
Innovation: Hospital Based Virtual Support www.caringvoices.ca Caring Voices provides an alternative means for providing and accessing supportive care through: Educational resources Regular monthly programming Online chats with experts and other survivors Forums for posting questions Friend matching that provides opportunity to find people with similar experiences
Thank You! Stephanie.phan@uhn.on.ca