Ms. Smith,Dr. Arfons, and Dr. Cmolik are co-directors of the Transforming and Integrating Medical and Surgical Expertise: Patient-Centered Specialty Care Education Center of Excellence at the Louis Stokes Cleveland VAMC (LSCVAMC) in Ohio. Ms. Smith is also on the clinical faculty at the Frances Payne Bolton School of Nursing, Case Western Reserve University (CWRU) and a survivorship nurse practitioner at the LSCVAMC, both in Cleveland, Ohio. Dr. Arfons is also a medical oncologist and the director of Hematology/Oncology at LSCVAMC and assistant professor at the CRWU School of Medicine. Dr. Cmolik is also a cardiothoracic surgeon and chief of surgery at LSCVAMC. Dr. Moye is a geriatric staff psychologist at the VA Boston Healthcare System and an associate professor of psychology in the Department of Psychiatry at Harvard Medical School, both in Boston, Massachusetts. Ms. Ballard was a clinical analyst at the VA Loma Linda Healthcare System (retired). Dr. Haggstrom is a primary care physician and health services researcher at the Center for Health Information and Communication, Richard L. Roudebush VAMC, and the Division of General Internal Medicine, Indiana University, both in Indianapolis, Indiana.
References
The following recommendations should be considered for the successful implementation of a new survivorship program:
Collect information from multiple resources to guide the establishment of the survivorship clinic;
Become familiar with the IOM From Cancer Patient to Cancer Survivor: Lost in Transition; 6
Understand local issues and barriers specific to your care delivery system;
Collaborate with key stakeholders from multiple specialties to gain momentum and buy-in;
Hold regular meetings with stakeholders as well as leadership to identify and remove barriers to the clinic success;
Join the VA Survivorship SIG to collaborate with other sites who have already started to pilot survivorship programs and discuss barriers to and successes of programs so as to not reinvent the wheel;
Utilize the Cancer Survivorship Toolkit;
Download the SCP;
Establish a close partnership with your local cancer committee; and
Collect and report data to show effectiveness and need.
All these strategies were vital to the success of the LSCVAMC survivorship program.
Summary
The VA is uniquely positioned to be a leader in highquality, comprehensive, and veteran-centered cancer survivorship care in the years ahead. The close relationship between specialty and primary care allows for smooth continuity of care and easy transitions between oncology and primary care. The comprehensive CPRS allows easy accessibility to information for the entire health care team. The Cancer Survivorship Toolkit provides a template of the survivorship care plan for the veteran and his or her health care providers.
The LSCVAMC is one of many VA institutions implementing quality care for cancer survivors and can serve as a role model for other VA programs initiating the survivorship care process (Table 2).
Author disclosures The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
