Debra Hesse Rachelle Portner, RN, BSN, BA

1. Survivorship Program Debra Hesse Survivorship Program Coordinator St. Mary’s Regional Cancer Center

4. Community Affiliates of the LIVE STRONG Survivorship Centers of Excellence in Colorado Denver Pueblo Grand Junction

19. Cancer Survivorship Services John Muir Health Meeting the Needs of Cancer Survivors; Throughout Treatment and Beyond Rachelle Portner, RN, BSN, BA Survivorship Nurse Navigator John Muir Cancer Institute

21. Distress Screening Survivorship Care Plan Treatment Summary Why is this so important?

29. NCCN Distress Screening Tool NCCN = National Comprehensive Cancer Network.

30. How are you doing today? Patient: Date:

32. Distress Screening I: Beginning of Treatment in Radiation Oncology

33. Distress Screening II: One Week Prior to Last Treatment in Radiation Oncology

35. Treatment Summary/ Care Plan for Distress Level <4

36. Treatment Summary/Care Plan (cont.)

37. Survivorship Patient Flow Identification of patient needs for Survivorship Services through distress screening Initiate Quality-of-Life Assessment to patients within 1 week of completion of treatment Consultation with Survivorship Nurse Navigator Initiation of Survivorship Care Plan Review assessments with patient, including acute and ongoing needs Treatment Summary Activation of JMH referrals and services for acute needs Referral to community-based resources as needed Cancer Support Community Other community-based resources Rehabilitation Services Psycho/Social Services Nutrition Services Introduction of survivorship services to patient by nurse navigator Managing Physician/Oncology Care Team Communication via Nurse Navigator and/or Patient Pastoral Care

38. Sample “Quality-of-Life Assessment for Cancer Survivors” (4 Domains of Quality of Life)

42. Survivorship Care Plan for Distress Level >4

52. Thank You Shell Portner, RN, BSN, BA Survivorship Nurse Navigator John Muir Cancer Institute 925-947-4462 [email_address]