Cancer G Survivorship ?· Marketing Strategies Survivorship programs ... , we found that a marketing…

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  • 36 Oncology IssuesJanuary/February 201236 Oncology IssuesJanuary/February 2012

    Gibbs Cancer Center is a designated NationalCancer Institute (NCI) Community CancerCenters Program (NCCCP) pilot site. AfterARRA(AmericanRecoveryandReinvestmentAct) funding was awarded to the NCCCP,

    GibbsCancerCenterwasoneofeightsitesidentifiedtospe-cifically develop a community survivorship program. Thenewprogramincludedastand-alonesurvivorshipclinicandanarrayofsupportandeducationalprograms.Theoverallgoalofthecomprehensivecommunitysurvivorshipprogramwastomeettheneedsofcancerpatientsassurvivorsintheirowncommunity.

    During implementation of the survivorship program,Gibbs Cancer Center faced numerous barriers, includinggainingacceptanceandbuy-infromitsmedicaloncologists.Tomeet these challenges,GibbsCancerCenterdevelopedmarketingandeducationalstrategiesandrecommendationsbasedonclinicaldata,casestudies,andresearch,aswellastheprofessionalopinionsofthesurvivorshipprogramcoor-dinator,nursenavigator,andkeystakeholders.

    Program Objectives & Outcomes Developinganewprogramatacommunitycancercenterrequires considerable time, effort, and resources. It alsorequires a group effort; all parties involved are vital totheprogramsoverallsuccess.Whilelogisticsvarywidelydependingontheprogramsscope, the targetpopulation,andthenumberof individualsororganizations involved,programimplementationshouldbewellplanned,withrolesandresponsibilitiesdelineatedcarefully.1

    Beforeimplementingitssurvivorshipprogram,GibbsCancerCenterfocusedonthreemainmarketingandedu-cationalobjectives:

    First, increase physician awareness of the need for additional survivorship care beyond that which patients were traditionally receiving. With increased physicianawareness, Gibbs Cancer Center hoped to gain buy-infrom oncologists who would then refer patients to thesurvivorshipclinic,aswellasothereducationalservices.

    Second, enhance hospital staff awareness of the new survivorship clinic and educational offerings.Theeduca-tionofstaffwouldaidindisseminatinginformationaboutthese new survivorship resources to patients. Specificinterventionstoincreasestaffawarenessincludedupdat-ingthehospitalsInternetandintranetsurvivorshipwebpagesandschedulingtalksatstaffandcommitteemeet-ings. Through successful education, we hoped to see ameasurable increase in class enrollment and referrals tothenewsurvivorshipclinic.

    Third, educate patients and the community about the survivorship clinic and its educational offerings.Thesuc-cessful education of patients and family members could

    by Regina Franco, MSN, NP-C; Marietta P. Stanton, PhD, RN, CCM, NEA-BC, CMAC, CNL; and Stacey S. Kindall, MPH

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    The effects of marketing and education on

    program implementation

    Cancer Survivorship Programs

    In BriefInthepastdecade,cancerpatientswhohavecompletedtheirintensivetreatmentshaveexpressedaneedforclearlyoutlinedcareplansthathelpthemtransitiontomaintenanceorfollow-upcare.Today,manycommunitycancercentersareimplementingsurvivorshipprogramstomeetthesepatientneeds.Marketingandeducationhelptocreateinternalbuy-infortheseprogramsultimatelycontributingtotheoverallsuccessofthenewprogram.Thisarticleexamineshowmarketingeffortsandeducationofkeystakeholdersimprovedphysician,staff,andpatientawarenessandencouragedbuy-inforthesurvivorshipprogramatGibbsCancerCenterinSpartanburg,S.C.

  • Oncology IssuesJanuary/February 2012 37Oncology IssuesJanuary/February 2012 37

    alsobemanifestedbyincreasedawarenessforpatientsandthecommunity.Specificactivitiessupportingtheseobjec-tivesincluded: Updating the hospitals Internet and intranet sur-

    vivorship web pages that describe the survivorshipclinicanditseducationalofferings

    Placing a calendar on the survivorship web page thathighlights the survivorship activities, including a livecontactnumberandemailforquestionsaboutthesur-vivorshipclinic

    Speakingatsupportgroupsandothercommunityactivi-ties.

    Toseehowwedidmeetingtheseobjectives,gotoSuccessStories&LessonsLearnedonpage40.

    Marketing StrategiesSurvivorship programs are a new innovation nationally.Anynewprogramrequires significantmarketing to thepublic and healthcare community to foster acceptance.Hospital subject matter experts often assume new andexistingstaffwillabsorbcertaininformation.Inourcase,wefeltthatafailuretoproperlyeducatestaffonthebasictenantsof the program and underlyingcomponentsofthesurvivorshipmovement would negativelyimpact implementation. Inten-siveeducationandcommunica-tion to staff is vital to improveunderstanding and buy-in. Inorder for our marketing staffto effectively promote our sur-vivorship program, we foundthat spending time with oursurvivorship team was impera-tive. An obvious first step wastoensurethateveryoneinvolvedintheprojecthadaclearunder-standing of what marketinginvolves.InANewMarketingPlaybook,authorNancyPatonsuggeststwoactions:21. Change your marketing strat-egy to win over todays patients from a value proposition stand-point.2. Move to a marketing message thats about patients, the stabil-ity of your healthcare organiza-tion, and the reasons your pro-gram pursues quality.

    Successfulmarketing involves anequal exchange inwhichbothpartiesexperienceabenefit.This,inturn,shouldleadtothedevelopmentofarelationship.3Effectivemarketingof a survivorship program can lead to bothbenefits toproviders and patients and a relationship between cancersurvivors and the survivorship program. Before a lastingpatientandhospitalrelationshipcanbedeveloped,how-ever,theremustfirstbeahospitalandstaffrelationship.Sobeginbymarketingyoursurvivorshipprogramwithinyourorganization.

    Whenstaffhasaclearunderstandingofthesurvivor-shipprogramanditsgoals,theycanthenactivelypromotetheprogram.ForGibbsCancerCenter,thismeantbrand-ing our programfirst internally and then externally.Alcorn and colleagues suggest that: An internal brandisthegluethatbindsthecultureandorganizationsothecompanycanmakegoodonitsexternalpromise.4Ifhos-pitalstaffisalignedwiththebrandstrategy,theywillbeabletocommunicateaconsistentexpressionofthebrandtopatients.5

    Withthisinmind,GibbsCancerCenterintroducedanewbrandplatformtopersonalizethecancercenter.

  • 38 Oncology IssuesJanuary/February 201238 Oncology IssuesJanuary/February 2012

    Weplacedasimplethreewordstatementpersonal. experience. sharedonallofourbrandingfortheGibbsCancerCenter(seelogo on page 36). Our branding strategywas designed to highlight the three mainvalue components of our cancer centersphilosophy.

    Education is KeyHospitals often assume that certain infor-mationiscommonplacetonewstaff.Inourcase, we found that a marketing staff inex-perienced in oncology (and without a solidunderstanding of which internal brandingthemesneededpromotion)combinedwithafailure toproperlyeducate staffon internalbrandingcouldnegativelyimpacttheimple-mentationofoursurvivorshipprogram.Twotakeaways:1)forourmarketingdepartmenttoeffectivelypromoteandbrandoursurvi-

    vorshipprogram,spendingtimewithoursurvi-vorshipteamwasimperative;and2)educatingourstaffaboutthenewcancersurvivorshipprogramwasessentialsothattheywouldbeable,inturn,toeducateanddeliverthismessagetoourcancersurvivors.

    In2008ChangandChangwrote:Themostimportant resources for an organization are nolongerrawmaterials,productiontechnique,ortheproduct itself,butratherwell-educated, service-orientedemployees.6Withoutpropereducation,ourstaffwouldfailtomakereferralstothesurvi-vorshipprogram.Worse,ourpatientsandfami-lies would be unaware of the new survivorshipprogram.Educationforstaffonthenewprogramwouldequipthemtodiscusstheseserviceswithourpatients.Further,weunderstoodthateduca-tionoftenresultsinincreasedconfidence.Inotherwords,whenstaffmembersareconfidentabouttheirknowledge,theyaremorewillingtobecome

    When staff

    has a clear

    understanding

    of the

    survivorship

    program and

    its goals,

    they can

    then actively

    promote the

    program.

  • Oncology IssuesJanuary/February 2012 39Oncology IssuesJanuary/February 2012 39

    engaged in program efforts. At Gibbs Cancer Center, wefoundthatphysiciansandclinicalstaffwhowereeducatedandknowledgeableonoursurvivorshipprogramincreasedreferralstoournewsurvivorshipprogram.

    Patienteducationisjustasimportant.Asthepivotal2005IOMreport,From Cancer Patient to Cancer Survivor: Lost in Transition, states: Healthcare providers, patient advo-cates,andotherstakeholdersshouldworktoraiseawarenessoftheneedsofcancersurvivors,establishcancersurvivor-shipasadistinctphaseofcancercare,andacttoensurethedelivery of appropriate survivorship care.7 Educating thecommunityaboutoursurvivorshipprogramwouldincreaseawarenessoftheseservices.Whilesurvivorshipprogramsareadirectresultoftheneedsofcancersurvivors,wefoundthatoftencancer survivors areunawareof availablepost-treat-mentresources.Educatingourcancerpatientscanhelpthemunderstandtheseservicesandseekoutsurvivorshipcareintheircommunities.

    Physician Buy-In Marketingandeducationcollectivelycreatebuy-in.Withbuy-in comes support from individuals, groups, depart-ments,andhospitaladministration,whichisimperativeforasurvivorshipprogram.Physiciansupportiskeybecause:8 Physiciansenrollpatientsinprograms. Mostdiseasemanagementinitiativesrequirephysician

    approvalbeforepatientscanenrollinaprogram. Patients frequently ask their physician whether they

    shouldenrollinaprogramofferedbytheirhealthcareplan.

    Programs that fail to gain widespread physician supporthavegreatdifficultyenrollingpatientsandusuallyexperi-enceenrollmentratesoflessthan50percent.8Conversely,programswithstrongphysicianbuy-incanachieveenroll-mentratesashighas80to90percent.8Physicianswhosup-

    port survivorship care as a distinct entity can help otherphysiciansunderstandhowsurvivorshipcareintheirhos-pital can improve quality initiatives internally, as well asmeetexternalbenchmarks.

    The Survivorship Clinic Visit and BeyondThemostopportunetimeforareferraltothesurvivorshipcliniciswhencancerpatientscompletetheirradiation,endo-crine,orchemotherapytreatment.Atourone-on-onesurvi-vorshipclinicvisit,survivorsmeetwithanursenavigatorandnursepractitioneranddevelopapersonalizedroadmapforthenextphaseofcare.Survivorsreceiveapersonalizedsurvi-vorshipcareplanbothapaperhardcopyandanelectronicversiononasecurity-encryptedflashdrive.Thiscareplaniscomposedofastagingsummary,atreatmentsummary,andapathologyreport.Weforwardacopyofthecareplantothepatientsoncologistandprimarycarephysician.Wealso: Provide follow-up care recommendations for cancer

    surveillance,aswellasvisitswithprimarycarephysi-ciansandspecialists.

    Makeanynecessaryreferrals. Assessthepatientsphysical,social,psychosocial,and

    spiritualneeds. Provide an overview of how survivorship directly

    relatestoeachpatient. Promote overall wellness education, including infor-

    mationondietandexercise.Referralstowellnesspro-gramsaremadeasneeded.

    HandoutaLifeafterTreatmentfolderandamanualoflocalandnationalsurvivorshipresources.

    Survivorsareencouragedtoattendtheeducationaloffer-ings held at our cancer center and, when appropriate, tobringtheircaregiversaswell.Theseclassesallowsurvivors

    Additional Online Content

    InJune2011GibbsCancerCenterreleasedthesecondeditionofitsbook,

    Pathways to Wellness: A Survivors Guide to Local Resources.Writtenbythe

    survivorshipprogramcoordinatorReginaFranco,MSN,NP-C,withhelpand

    inputfromMariettaP.Stanton,PhD,ReggieScoggins,RN,PerryPatterson,and

    volunteercancersurvivorsKayMcClure,HollieWalker,andLaurensFlanagan.

    This54-pagebookisdistributedtoallcancerpatientswhovisitthesurvivorship

    clinic.Contentsincludeinformationaboutnutrition,exercise,survivorship

    careplans,asurvivorshipreadinglist,andmore.Itisavailableonlineat:

    www.accc-cancer.org/oi/JF2012.Publicationoftheguidewasmadepossible

    byagrantfromtheSouthCarolinaCancerAlliance.

    (continued on page 41)

    http://www.accc-cancer.org/oi/JF2012

  • To enhance physician awareness and encourage physician buy-in of the survivorship program,wecirculatedpeer-reviewedpubli-cationshighlightingsurvivorsneedsandexamplesofdocu-mentsgeneratedinourSurvivor-shipClinictophysiciansandstaff.DuringthecourseoftheNCCCPpilotproject,wereal-izedthatnursesandnurseprac-titionersplayasignificantroleinremindingphysiciansofnewinitiatives.Thesuccessofoursurvivorshipprogramdependedgreatlyuponthereferralsfromtheseclinicians,sowesimplifiedthereferralprocessbycreatingprescriptionpadsdesignedtoencourageparticipationinsur-vivorshipinitiatives.Oursurvi-vorshipcliniccoordinatoralsoengagedoncologistsatweeklyandmonthlyclinicalmeetings.Soonourphysiciansbecamestakeholdersandencouragedeacheligiblepatienttotakepartinthesurvivorshipprogram,clinic,andeducationalofferings.Moreover,weintroducedanautomaticentrypromptinourelectroniccheck-out.

    To enhance internal awareness of the survivorship program and improve interdepartmen-tal relationships,wedeliveredpresentationstovarioushospitaldepartments.Weinvitedmar-ketingstafftoparticipateinourcancersurvivorshipcommitteemeetingsandprovideuswithinput.Inthefuture,weplanoneducatingnewstafforstaffwithlimitedoncologyexperiencepriortoprogramimplementa-tionsothattheybuyintotheinitiativefromthebeginning.Wealsoplanondeliveringsurvivor-

    shippresentationstovarioushospitalcommitteescomposedofhospitalemployeesfromdifferentdepartments.

    To share information about the survivorship program with our local community,wehaveplacedsignagethroughoutthehospitalandsurvivorshippublicationsinthemonthlyactivitiescalendarmailing.Weplanondistribut-ingflyersandannouncementstolocalchurcheswithhealthmin-istries.Wealsoplantomeetwithestablishedsupportgroupsandcommitteestocreateawarenesswithinthosegroups.

    To provide education and create awareness to patients,wecre-atedinformationaltentcardstoplaceatcheck-inandcheck-outstations.Thesetentcardsletpatientsknowwhatresourcesareavailableandhowwecanservethem.Whilethesurvivorshipclinicvisitrequiresaphysicianreferral,educationalclassesareopentoallcancersurvivors.

    To improve the web presence of the survivorship program,wemadechangestothehospitalsintranetandInternetwebsites.Withthesechangeswebrandedourinitiativesclearlyandkeepthemintheforefrontofthemindsofbothpatientsandemployees.Thisisoneareathatwasparticularlychallenging,somarketingorITstaffskilledatwebdevelopmentiskey.Wefoundthatupdatingthesewebpageswasverytimeconsumingandinvolvedseveralstepsforeachupdateorchange.Often,therequestcouldnotbedone

    becauseofdesignlimitationsofthewebpages.Therearemanynuancestowebupdating,suchasdifferentfilerequirementstouploadadocumenttobeviewedonlyascomparedtoadocumentthatwillbeviewedandalsoprinted.Inaddition,wewerechallengedbylimitedresources.Consideringthesizeofourhos-pital,ourmarketingdepartmentisquitesmall.Further,thereareseveralmajorprogramsdevel-opingwithinourcancercentersimultaneously.Consequently,marketingstaffcouldspendonlyasmallamountoftimeoneachnewinitiativeorprogram.

    To measure the success of our survivorship program,oursurvivorshipcliniccoordina-torcollectedquarterlydatasummarizingreferralpatterns.Datacollectedrelatedtowhichoncologistshadhigherreferralsandwhattypesofreferralsweregeneratedasaresultofthesur-vivorshipvisit.Usingthisinfor-mation,wedevelopedabusinessplanthatincludeddow...

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