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Ulrike Gorgens
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P13 - Health Services Research/Health Economics - Misc. Topics (ID 219)
- Event: WCLC 2020
- Type: Posters
- Track: Health Services Research/Health Economics
- Presentations: 1
- Moderators:
- Coordinates: 1/28/2021, 00:00 - 00:00, ePoster Hall
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P13.03 - The Role of Nurse Practitioners Within Thoracic Radiation Oncology and the Benefit to Patients, Physicians and the Healthcare System (ID 1972)
00:00 - 00:00 | Presenting Author(s): Ulrike Gorgens
- Abstract
Introduction
The role of NPs within thoracic radiation oncology has evolved over time. At our National Cancer Institute (NCI) comprehensive center we instituted a nurse practitioner (NP)lead survivorship care model for thoracic radiation oncology in order to standardize follow-up.
Methods
We designed a model to optimize MD availability to see new patients and allow NPs to focus on follow up care. After radiation treatment was completed, patients would transition follow-up care to the thoracic NP, with the thoracic NP clinic occurring simultaneously with the Attending rad onc physician. NP was involved in patient care while on radiation treatment to manage treatment related side effects and other issues. Patients were scheduled for first follow-up to occur about 4-6 weeks after radiation was complete. Surveillance imaging consisting of chest CT w/IV contrast was performed every 3-6 months and other imaging, including PET CT as clinically indicated. All imaging studies were reviewed by Attending physician. If new cancer recurrence was suspected, the patient was scheduled for re-evaluation with Attending. Afterwards patients transitioned to NP led survivorship clinic. Patients were follows for 5 years or until progression that necessitated active treatment.
Surveillance Protocol:
ResultsDisease
Surveillance
Stage I non-small cell lung cancer—medically inoperable
12 weeks post tx CT chest, with CT chest q 4 to 6 months thereafter.
Stage III non-small cell lung cancer treated with chemo-RT followed by immunotherapy
Med onc visit within 2 weeks after completion of radiation.
Rad Onc visit q 6 months with CT chest for 5 years or until disease progression.
Limited stage small cell lung cancer
12 weeks post tx CT chest, with CT chest q 3 to 6 months thereafter.
MRI brain 4 weeks post chemoradiation to assess for prophylactic cranial irradiation.
Brain mets treated with SRS
MRI brain with and without contrast q 3 months for 1 year, then q 6 months.
Palliative radiation treatment
6 weeks post-treatment follow-up to assess for symptom resolution. Imaging as needed.
Over a 2-year period 245 new thoracic consults were seen by thoracic lead team radiation oncology. Lead thoracic NP saw 395 thoracic follow-ups. Attending saw 232 thoracic return visit evaluations.
Patient satisfaction with NP led clinic = between 93-100 % per Press Ganey patient surveys.
Conclusion
This NP lead survivorship care model optimizes MD availability for newly diagnosed patients and allows NPs to fully engage in follow-up care for thoracic patients. This model is feasible within a NCI comprehensive cancer center.
This survivorship paradigm creates a supportive environment for follow up care that leads to high levels of patient satisfaction.
