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U Penn Abramson Cancer Center Living Well After Cancer Survivorship Center Philadelphia, PA Clinical Setting: • Survivorship care is part of the continuum of care within the Oncology Clinic • Breast cancer patients are given their Survivorship Care Plan and Treatment summary by their oncologists • Generally breast cancer patients are internally referred on the recommendation of their oncologist to the survivorship program around 5 years from diagnosis, but that’s not the mandate • Visit is like any other oncology follow-up appointment but longer • Survivorship Clinic held on Fridays (one day a week) • Patient returns to same clinic, same waiting area, same labs, and same location of their oncologist • The only change is that they are seen by the nurse practitioner who manages the survivorship clinic o Covers more survivorship issues o Patient reported outcomes o What patients might be experiencing o Surveillances are kept up to date o Referrals to appropriate specialists (i.e. rehab, nutritional counseling, weight gain, acupuncture) • Patients come yearly as part of their oncology follow-up • Some patients see their oncologist one year and the survivorship nurse the other year in attempt to transition patients away from oncologist Staffing: • Nurse practitioner who is only dedicated to the survivorship clinic one day a week Patient Population: • 200 Patient visits a year that are identified specifically for survivorship program • Urban setting, white urban educated, higher socio-economic status • Located in West Philadelphia • 15%-20% African American • Reflective of population in the area Funding: • Initially funded by a seed grant from the Livestrong Foundation • Research funding • All nurse practitioner appointments are fully reimbursable • Integrative Services (i.e. reiki, massage, acupuncture) are not reimbursable, unless patient qualifies for a research study • Rehab is reimbursable post treatment to an extent, but co-pays are high Integrative Medicine Programs (Cancer Supportive Services) • Integrative supportive services are designed to help patients cope with the cancer experience o Acupuncture o Diet and Nutrition o Mindfulness- Based Stress Reduction Therapy o Massage o Reiki o Yoga o Exercise/Rehabilitation 1 Challenges: • Longer term cancer patients who have been seeing their oncologists longer than the survivorship clinic has operated, may refuse to be transitioned to the survivorship clinic Lessons Learned: • Working within an existing system rather than trying to create something new, is less difficult to monitor and set-up • Working within the system allows for a seamless transition for patients 2