TABLE 1.

Selected Barrier and Potential Changes or Solutions to Address Them

Barrier	Assessment of Work System Elements Using SEIPS	Potential Desired Changes or Strategies
Reliance on static unidirectional care plan processes	Task: Updates not being performed	Task: Dynamic updates of survivorship information; design and implement workflows to support these tasks, including assignment of responsibilities
	Organization: Poor transfer of information across health care systems	Organization: Improve transfer of information; greater EHR interoperability, better data-sharing agreements
	Persons: Lack of defined person responsible, no workflows	Persons: Identify individuals or group within organization responsible, design formal processes for persons to acknowledge responsibilities
	Tools/tech: Do not support updating SCP content without considerable personnel and time resources	Tools/tech: Clinical workflows to support discrete data capture, use of discrete HER data to support automatic updates, design processes that leverage EHR ability to check and process data in real-time
	Environment: National standards do not require updates	Environment: Standards adopted to suggest/require updates, clear assignment of responsibilities

Abbreviations: EHR, electronic health record; SCP, survivorship care plan; SEIPS, Systems Engineering Initiative for Patient Safety.