Supporting Implementation of the National Standards for Cancer Survivorship Care: Development of the Cancer Survivorship Maturity Model (CSMM)

Abstract Purpose. National survivorship care standards define the domains of care that healthcare organizations should deliver, yet few tools exist to assess readiness for implementation. We developed and preliminarily evaluated the Cancer Survivorship Maturity Model (CSMM), a framework designed to assess organizational readiness to implement survivorship care standards. Methods. We conducted a mixed-methods, participatory model development study. A preliminary CSMM, grounded in national survivorship care standards, 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 iterative 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 from the National Cancer Institute Survivorship Supplement Awardees network 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. Across internal and external applications, 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 readiness for survivorship care implementation and to identify domain-specific gaps. Implications for Cancer Survivors. By helping institutions target areas for improvement and resource investment, the CSMM may support more consistent, coordinated, and patient-centered survivorship care delivery.