Supporting implementation of the national standards for cancer survivorship care: development of the cancer survivorship maturity model (CSMM)
8 affiliations
- 1Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX USA
- 2McWilliams School of Biomedical Informatics,UTHealth, Houston, USA
- 3Department of Medicine, Baylor College of Medicine, Houston, TX USA
- 4Lester and Sue Smith Breast Cancer Center, Baylor College of Medicine, Houston, TX USA
- 5Dell Medical School, The University of Texas at Austin, Austin, TX USA
- 6Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA USA
- 7Sidney Kimmel Comprehensive Cancer Center, Philadelphia, PA USA
- 8Department of Medical Oncology, Thomas Jefferson University, 834 Chestnut St, Philadelphia, PA 19104 USA
Abstract
Purpose: The National Standards for Cancer Survivorship Care define the domains of care that healthcare organizations should deliver, yet few tools exist to assess organizational capability and implementation maturity for the National Standards. We developed and preliminarily evaluated the cancer survivorship maturity model (CSMM), a framework designed to assess organizational maturity in real-world oncology settings.
Methods: We conducted a mixed-methods, participatory model development study. A preliminary CSMM was refined through five multidisciplinary focus groups at a comprehensive cancer center using consensus-building techniques adapted from nominal group technique. Participants completed prioritization exercises, contributed to model refinement, and assessed the maturity of survivorship care delivery in their practice settings. Qualitative analysis identified model refinement needs and implementation barriers. The final model was distributed to external stakeholders for preliminary evaluation.
Results: Fourteen internal participants and 12 external respondents contributed to model development and evaluation. The final CSMM included seven domains across five maturity levels ranging from ad hoc to optimized. Participants identified differences in prioritization across clinical impact, implementation feasibility, and perceived patient importance. Participants’ assessment of survivorship care maturity was generally low, with most domains clustering between levels 1 and 2. Qualitative findings identified barriers, including unclear workflows, limited resources, insufficient time, and technical constraints.
Conclusions: The CSMM provides a structured approach to assess organizational capability and implementation maturity for the National Standards while identifying domain-specific opportunities for improvement.
Implications for Cancer Survivors: By helping institutions target areas for improvement and resource investment, the CSMM may support more consistent patient-centered survivorship care delivery.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02131-0.
Related
- Financial concerns: a critical gap in survivors’ experience of the implementation of the national standards for cancer survivorship care
- The national standards for cancer survivorship care in action: caregiver experiences across stage, phase, and geography
- Contextual assessment of perceived health system alignment with National Standards for Cancer Survivorship Care in the American Southeast
- Understanding and advancing alignment of the national standards for cancer survivorship care for adolescents and young adults: challenges and opportunities
- Development of consensus-based standards for a National Clinical Audit of Perioperative Care: protocol for a modified Delphi consensus study.
BibTeX
@article{dowst2026supporting,
title = {{Supporting implementation of the national standards for cancer survivorship care: development of the cancer survivorship maturity model (CSMM)}},
author = {Heidi Dowst and Maryem Shirzadi and Martha Mims and Susan Hilsenbeck and Liwei Wang and Hoda Badr},
journal = {Journal of Cancer Survivorship},
year = {2026},
month = oct,
doi = {10.1007/s11764-026-02131-0},
url = {https://doi.org/10.1007/s11764-026-02131-0},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Supporting implementation of the national standards for cancer survivorship care: development of the cancer survivorship maturity model (CSMM)
AU - Heidi Dowst
AU - Maryem Shirzadi
AU - Martha Mims
AU - Susan Hilsenbeck
AU - Liwei Wang
AU - Hoda Badr
PY - 2026
DA - 2026/10/01
JO - Journal of Cancer Survivorship
DO - 10.1007/s11764-026-02131-0
UR - https://doi.org/10.1007/s11764-026-02131-0
AB - Purpose: The National Standards for Cancer Survivorship Care define the domains of care that healthcare organizations should deliver, yet few tools exist to assess organizational capability and implementation maturity for the National Standards. We developed and preliminarily evaluated the cancer survivorship maturity model (CSMM), a framework designed to assess organizational maturity in real-world oncology settings. Methods: We conducted a mixed-methods, participatory model development study. A preliminary CSMM was refined through five multidisciplinary focus groups at a comprehensive cancer center using consensus-building techniques adapted from nominal group technique. Participants completed prioritization exercises, contributed to model refinement, and assessed the maturity of survivorship care delivery in their practice settings. Qualitative analysis identified model refinement needs and implementation barriers. The final model was distributed to external stakeholders for preliminary evaluation. Results: Fourteen internal participants and 12 external respondents contributed to model development and evaluation. The final CSMM included seven domains across five maturity levels ranging from ad hoc to optimized. Participants identified differences in prioritization across clinical impact, implementation feasibility, and perceived patient importance. Participants’ assessment of survivorship care maturity was generally low, with most domains clustering between levels 1 and 2. Qualitative findings identified barriers, including unclear workflows, limited resources, insufficient time, and technical constraints. Conclusions: The CSMM provides a structured approach to assess organizational capability and implementation maturity for the National Standards while identifying domain-specific opportunities for improvement. Implications for Cancer Survivors: By helping institutions target areas for improvement and resource investment, the CSMM may support more consistent patient-centered survivorship care delivery. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s11764-026-02131-0.
SN - 1932-2259
SN - 1932-2267
ER -