Surviving and Thriving

Contact Name: 
Peggy Kupres
Name of Institution, Organization or Community Where the Project Was Implemented: 
Advocate Christ Medical Center - Oak Lawn, Illinois, Advocate South Suburban Hospital - Hazel Crest, Illinois and Gilda's Club Chicago
Description of Project Setting: 

Advocate Christ Medical Center (ACMC) is a not-for-profit, 749-bed, premier teaching institution with nearly 1,300 affiliated physicians, ACMC serves as a major referral hospital in the Midwest for a number of specialties, including cardiovascular services; heart, lung and kidney transplantation; neurosciences; oncology; orthopedics; and women’s health. As a major teaching institution, the medical center annually trains more than 400 residents, 600 medical students, and 800 nursing students. Advocate Christ Medical Center diagnoses almost 2000 patients with cancer per year.

Gilda’s Club Chicago (GCC) at ACMC is an integral part of the cancer center. In 2015, GCC served more than 500 patient and family member visits. GCC at ACMC provides free support for the whole family, the whole time throughout their cancer experience. Located on the ground floor of the Advocate Christ Medical Center Outpatient Pavillion.
Advocate South Suburban Hospital is a 291 bed, not-for-profit, acute care, community hospital located in one of Chicago's southern suburbs, Hazel Crest, Illinois. As a member of the Advocate Health Care System, South Suburban Hospital provides a wide range of comprehensive inpatient services for medical/surgical, cardiac, obstetric, pediatric, orthopedic, oncology and diabetes care. The patient population is multi-cultural and multi-racial including people with roots in Africa, Europe, India, Latin America and the Middle East. The surrounding neighborhoods and communities are among the most well-integrated communities in Chicagoland. Advocate South Suburban Hospital diagnosed over 260 patients with cancer last year.

Quality of Life
Target Population: 
Cancer Site: 
Project Description: 

Surviving and Thriving is a monthly patient education class. Surviving and Thriving was developed in 2012 by Peggy Kupres, Manager of the ACMC Center for Breast Care and 11-year cancer survivor. Each session began with a 15-minute “Nutrition in a Nutshell” given by a dietician and focused on healthy eating options. This was followed by a 40-minute lecture focusing on different Survivorship topics each month, such as: Late and Long-Term Effects of Treatment, Exercise, Healthy Eating, Mindfulness, How to Talk with Your Doctor, Estate Planning, Sexuality After Cancer, etc. The topics were chosen by the patients on their evaluations throughout the sessions and conducted by specialists in the content. Each session ended with a 20-minute exercise program conducted by a physical therapist. After founder of Surviving and Thriving left ACMC, the program was continued by Gilda’s Club Chicago at ACMC and introduced to their downtown Chicago main clubhouse. The program continues today without the nutrition exercise portion.

Problem or Issue the Project Was Designed to Address or Improve: 

The program was designed to address the limited patient education opportunities available at the time. The lectures reinforced items addressed in patients’ care plan discussion and to address their fears. The diet and exercise portions were designed to hardwire the evidence-based importance of both for cancer survivors.

Difficulties Encountered in Planning, Implementing, Evaluating or Sustaining the Project: 
Funding was an issue. The program was provided by staff as volunteers. A healthy snack was provided by the ACMC Cancer Institute. When the Survivorship Coordinator Position was eliminated, the program transitioned to Gilda’s Club Chicago at ACMC.
Project Successes: 
We had an average of 30 patients per month attend, at least 15 attended monthly and others trickled in as the topic interested them. The calendar was created a year in advance from the evaluations from the previous year. Initially, marketing was a struggle – how do we get the word out? Once patients and family attended, they brought other survivors to the presentations as well. Patients encouraged their physicians to let all of their patients know about the program. Our Oncology Nurse Navigators gave our flyers to all patients they came in contact with. Although flyers for Surviving and Thriving were available in the radiation and infusion departments, patients did not always take them. The survivor coordinator began rounding daily and talking with the patients about the program and the numbers began to climb. The successes of Surviving and Thriving positioned us for subsequent success. Based on Surviving and Thriving’s success, we created a Boot Camp exercise program and applied for multiple grants. We received and Illinois Department of Public Health (IDPH) Ticket for a Cure grant to develop the program for Breast Cancer patients – Breast Cancer Boot Camp (BC2). This was a 7-week, 2 night per week exercise program for breast cancer survivors. Ove the course of the program, 140 patients were enrolled. When the grant period was completed, Boot Camp was continued at ACMC by Gilda’s Club Chicago opening participation to all cancer survivors. BC2 was replicated at Advocate South Suburban Hospital in partnership with the Cancer Support Community, where 85 patients were reached due to a second grant from IDPH. When BC2 ended, due to patient interest to continue exercising, we developed a 12-week walk to run program – Moving Beyond Cancer. In 2016, we had 18 patients participate. Twelve patients participated in the Colon Cancer Coalition’s Get Your Rear in Gear 5k and 3 of our patients placed in their age group! None of them had ever done a 5k before! We already have 25 participants registered for Moving Beyond Cancer this year and registration just opened last week. Evaluations coming back from the patients were overwhelmingly positive. Physicians who presented at the program became champions for the program. Patients were educated on topics that all survivors face, regardless of site of cancer origin. Patients became very supportive of each other. A large group of them get together for dinner monthly. A list serve of attendees was created and patients receive information on survivorship topics and upcoming educational opportunities within the community. Patients expressed desire to learn about the ongoing effects of a cancer diagnosis and treatment. They stated through evaluations that they were empowered by the knowledge they gained at the presentations.
Helpful Information Before the Project Started: 
More information on successful marketing strategies would have been helpful. Upfront funding would have enabled us to expand the program earlier than we were able to. Identifying a physician champion upfront would have been helpful to educate other physicians on what the program was. Conducting a quality of life study would have helped us to gauge our impact even further than the evaluations. The results of a study would have helped to further identify the patients’ needs.
Project Significance: 
The project was significant in that it not only filled a gap in the unaddressed survivorship needs, but also that it was flexible enough to be responsive as new needs were identified. It positioned us to build on successes by developing and successfully applying for funding for subsequent programs. The program helped cultivate relationships across individual partners (e.g. clinicians) and organizations (e.g. Gilda’s Club Chicago and the Cancer Support Center).
Lessons Learned for Patients, Caregivers and/or Communities: 
By educating patients in a group setting, the SCP visit was better able to respond to survivors’ individualized needs. The visit became a short recap of the information already covered and an in debt discussion of new topics. This shortened the visits of the attendees by approximately 20 minutes or longer.
Lessons Learned for Clinicians or Health Care Professionals: 
Knowledge is power. By providing our patients the information they requested, we empowered them to become more involved in their care and follow-up. Survivorship care plan presentations were much more interactive with participants who participated in Surviving and Thriving. We were able to identify and leverage efficiencies from Surviving and Thriving into our SCP process as described above.
Lessons Learned for Researchers or Additional Research Needed: 
Future research could focus on a quality of life study to better measure our outcomes. We did a study with BC2. All measures showed a statistically significant difference in fatigue, sexuality and overall well-being in all participants. A similar study for participants in a program like Surviving and Thriving would be helpful to measure the benefits of educating cancer survivors on survivorship needs.