Implementing a Prospective Surveillance Physical Therapy Program for Those Affected by Cancer

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Background

This program implements a prospective surveillance physical therapy program to prioritize the well-being and quality of life of individuals affected by cancer, particularly veterans, by overcoming barriers associated with the prospective surveillance model (PSM) and lessening negative treatment effects. Recent cancer care research emphasizes the significance of PSM and prehabilitation in improving outcomes and mitigating the adverse effects of cancer and its treatments. However, barriers hinder PSM implementation despite its established efficacy in managing cancer-related dysfunctions. Notably, current cancer treatment lacked physical therapy (PT) consultation for cancer rehabilitation.

Methods

A new care model was developed, incorporating PT consultation at cancer diagnosis for veterans with cancer. Comprehensive clinical education and necessary equipment were provided to PTs for high-quality treatment. A cancer rehabilitation guidebook was created and distributed to educate patients and cancer providers in VA hospital and community-based outpatient clinics. Veterans with cancer diagnoses have access to physical therapy services at any time during cancer treatment and survivorship. Data were collected and analyzed to identify trends in cancer rehab PT consults.

Results

The biggest barrier to PSM was a lack of knowledge about its efficacy and available services. Before FY23, no cancer rehab PT consults were conducted. FY23, 47 PT consults were conducted, increasing to 79 consults in FY24 through 05/31/24.

Conclusions

PT services are needed throughout the cancer journey for veterans, from diagnosis to treatment and survivorship. This project demonstrates the feasibility of developing a PSM with a cancer rehabilitation PT consult. Utilizing established surveillance intervals can minimize cancer-related sequelae. Other VA medical centers can adopt similar PSMs in PT to improve functional outcomes and minimize the negative impacts of cancer and its treatments.

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Background

This program implements a prospective surveillance physical therapy program to prioritize the well-being and quality of life of individuals affected by cancer, particularly veterans, by overcoming barriers associated with the prospective surveillance model (PSM) and lessening negative treatment effects. Recent cancer care research emphasizes the significance of PSM and prehabilitation in improving outcomes and mitigating the adverse effects of cancer and its treatments. However, barriers hinder PSM implementation despite its established efficacy in managing cancer-related dysfunctions. Notably, current cancer treatment lacked physical therapy (PT) consultation for cancer rehabilitation.

Methods

A new care model was developed, incorporating PT consultation at cancer diagnosis for veterans with cancer. Comprehensive clinical education and necessary equipment were provided to PTs for high-quality treatment. A cancer rehabilitation guidebook was created and distributed to educate patients and cancer providers in VA hospital and community-based outpatient clinics. Veterans with cancer diagnoses have access to physical therapy services at any time during cancer treatment and survivorship. Data were collected and analyzed to identify trends in cancer rehab PT consults.

Results

The biggest barrier to PSM was a lack of knowledge about its efficacy and available services. Before FY23, no cancer rehab PT consults were conducted. FY23, 47 PT consults were conducted, increasing to 79 consults in FY24 through 05/31/24.

Conclusions

PT services are needed throughout the cancer journey for veterans, from diagnosis to treatment and survivorship. This project demonstrates the feasibility of developing a PSM with a cancer rehabilitation PT consult. Utilizing established surveillance intervals can minimize cancer-related sequelae. Other VA medical centers can adopt similar PSMs in PT to improve functional outcomes and minimize the negative impacts of cancer and its treatments.

Background

This program implements a prospective surveillance physical therapy program to prioritize the well-being and quality of life of individuals affected by cancer, particularly veterans, by overcoming barriers associated with the prospective surveillance model (PSM) and lessening negative treatment effects. Recent cancer care research emphasizes the significance of PSM and prehabilitation in improving outcomes and mitigating the adverse effects of cancer and its treatments. However, barriers hinder PSM implementation despite its established efficacy in managing cancer-related dysfunctions. Notably, current cancer treatment lacked physical therapy (PT) consultation for cancer rehabilitation.

Methods

A new care model was developed, incorporating PT consultation at cancer diagnosis for veterans with cancer. Comprehensive clinical education and necessary equipment were provided to PTs for high-quality treatment. A cancer rehabilitation guidebook was created and distributed to educate patients and cancer providers in VA hospital and community-based outpatient clinics. Veterans with cancer diagnoses have access to physical therapy services at any time during cancer treatment and survivorship. Data were collected and analyzed to identify trends in cancer rehab PT consults.

Results

The biggest barrier to PSM was a lack of knowledge about its efficacy and available services. Before FY23, no cancer rehab PT consults were conducted. FY23, 47 PT consults were conducted, increasing to 79 consults in FY24 through 05/31/24.

Conclusions

PT services are needed throughout the cancer journey for veterans, from diagnosis to treatment and survivorship. This project demonstrates the feasibility of developing a PSM with a cancer rehabilitation PT consult. Utilizing established surveillance intervals can minimize cancer-related sequelae. Other VA medical centers can adopt similar PSMs in PT to improve functional outcomes and minimize the negative impacts of cancer and its treatments.

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Developing a Cancer Rehabilitation Program—Improving Access to Ancillary Services to Mitigate the Impact of Cancer and its Treatments for Veterans Diagnosed With Cancer

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Background

Approximately 56,000 Veterans are diagnosed with cancer every year in the VA system. Up to 90% of survivors have at least one impairment that decreases their quality of life, but only 2-9% are receiving cancer rehabilitation. Current research in cancer care demonstrates the importance of prospective surveillance, rehabilitation, and a multidisciplinary (MultiD) approach to cancer survivorship. Multi-D treatments help mitigate the effects of cancer and its treatments as the veterans proceed through care, improve outcomes, and streamline the process to meet all rehabilitation needs for those affected by cancer. Prior to the development of this program all services except navigation were available. Those diagnosed with cancer were not receiving prehabilitation and consults to ancillary services did not occur until after active cancer treatment was completed. CCRP united existing Multi-D programs to better serve the needs of veterans with cancer. Development of the CCRP CPRS Consult menu has allowed for improved access for both providers and veterans.

Methods

Identified the need for ancillary services during cancer survivorship, regardless of Veterans treatment location within or outside the VA system. Initiated tracking via CCR consults, developed a CCRP guidebook to identify all services available and how to access them as well as the CCCRP consult menu to create easier access for providers and veterans. Tracking via Multi-D departments that allow for tracking in CPRS via CCRP Consult.

Results

Prior to FY23 no cancer rehab consults existed. Consults received since program implementation: Navigation: 144, Physical Therapy: 102, Occupational Therapy: 7, Speech: 15. All other Multi-D did not track CCRP-specific consults. Other tools for data analysis are utilized in other departments in which gaps in coordination of care have been caught/resolved, and advocacy has increased.

Conclusions

Comprehensive cancer care from diagnosis throughout survivorship improves quality of life. A Multi-D comprehensive Cancer rehabilitation provides an opportunity to streamline care via a CPRS Menu. Other VA medical centers can develop a Multi-D cancer rehabilitation program to coordinate treatments from diagnosis through survivorship. This is an opportunity to make the VA the forefront of oncology care – by providing all services within one system.

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Federal Practitioner - 41(9)s
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S38
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Background

Approximately 56,000 Veterans are diagnosed with cancer every year in the VA system. Up to 90% of survivors have at least one impairment that decreases their quality of life, but only 2-9% are receiving cancer rehabilitation. Current research in cancer care demonstrates the importance of prospective surveillance, rehabilitation, and a multidisciplinary (MultiD) approach to cancer survivorship. Multi-D treatments help mitigate the effects of cancer and its treatments as the veterans proceed through care, improve outcomes, and streamline the process to meet all rehabilitation needs for those affected by cancer. Prior to the development of this program all services except navigation were available. Those diagnosed with cancer were not receiving prehabilitation and consults to ancillary services did not occur until after active cancer treatment was completed. CCRP united existing Multi-D programs to better serve the needs of veterans with cancer. Development of the CCRP CPRS Consult menu has allowed for improved access for both providers and veterans.

Methods

Identified the need for ancillary services during cancer survivorship, regardless of Veterans treatment location within or outside the VA system. Initiated tracking via CCR consults, developed a CCRP guidebook to identify all services available and how to access them as well as the CCCRP consult menu to create easier access for providers and veterans. Tracking via Multi-D departments that allow for tracking in CPRS via CCRP Consult.

Results

Prior to FY23 no cancer rehab consults existed. Consults received since program implementation: Navigation: 144, Physical Therapy: 102, Occupational Therapy: 7, Speech: 15. All other Multi-D did not track CCRP-specific consults. Other tools for data analysis are utilized in other departments in which gaps in coordination of care have been caught/resolved, and advocacy has increased.

Conclusions

Comprehensive cancer care from diagnosis throughout survivorship improves quality of life. A Multi-D comprehensive Cancer rehabilitation provides an opportunity to streamline care via a CPRS Menu. Other VA medical centers can develop a Multi-D cancer rehabilitation program to coordinate treatments from diagnosis through survivorship. This is an opportunity to make the VA the forefront of oncology care – by providing all services within one system.

Background

Approximately 56,000 Veterans are diagnosed with cancer every year in the VA system. Up to 90% of survivors have at least one impairment that decreases their quality of life, but only 2-9% are receiving cancer rehabilitation. Current research in cancer care demonstrates the importance of prospective surveillance, rehabilitation, and a multidisciplinary (MultiD) approach to cancer survivorship. Multi-D treatments help mitigate the effects of cancer and its treatments as the veterans proceed through care, improve outcomes, and streamline the process to meet all rehabilitation needs for those affected by cancer. Prior to the development of this program all services except navigation were available. Those diagnosed with cancer were not receiving prehabilitation and consults to ancillary services did not occur until after active cancer treatment was completed. CCRP united existing Multi-D programs to better serve the needs of veterans with cancer. Development of the CCRP CPRS Consult menu has allowed for improved access for both providers and veterans.

Methods

Identified the need for ancillary services during cancer survivorship, regardless of Veterans treatment location within or outside the VA system. Initiated tracking via CCR consults, developed a CCRP guidebook to identify all services available and how to access them as well as the CCCRP consult menu to create easier access for providers and veterans. Tracking via Multi-D departments that allow for tracking in CPRS via CCRP Consult.

Results

Prior to FY23 no cancer rehab consults existed. Consults received since program implementation: Navigation: 144, Physical Therapy: 102, Occupational Therapy: 7, Speech: 15. All other Multi-D did not track CCRP-specific consults. Other tools for data analysis are utilized in other departments in which gaps in coordination of care have been caught/resolved, and advocacy has increased.

Conclusions

Comprehensive cancer care from diagnosis throughout survivorship improves quality of life. A Multi-D comprehensive Cancer rehabilitation provides an opportunity to streamline care via a CPRS Menu. Other VA medical centers can develop a Multi-D cancer rehabilitation program to coordinate treatments from diagnosis through survivorship. This is an opportunity to make the VA the forefront of oncology care – by providing all services within one system.

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