Improved Early Referral in Long-Term Survivor Care With Institutional Standardized Practice Among Childhood Leukemia Survivors.
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In 2018, the Texas Children's Cancer and Hematology Center Leukemia Program implemented a practice standard to support the transition from treatment to survivorship that includes shared, alternating care between leukemia and survivorship clinicians and a reminder to refer survivors to the long-term survivor clinic (LTSC) 2 years after treatment. We evaluated the impact of this standard on LTSC attendance, early initiation, and follow-up. Implementation was associated with early LTSC initiation, and early initiation was associated with subsequent LTSC follow-up. Standardized referral processes and communication across care teams may improve survivorship care, although sociodemographic disparities in attendance and loss-to-follow-up persist.