Supporting implementation of the national standards for cancer survivorship care: development of the cancer survivorship maturity model (CSMM)

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.