Introducing oncology nurse navigators (ONNs) at the point of entry to a comprehensive cancer center decreased the time from diagnosis to treatment, according to research presented at the Academy of Oncology Nurse & Patient Navigators 14th Annual Navigation & Survivorship Conference.
Jill Susanne Hyson, MSN, NP-C, AOCNP, of Atrium Health Wake Forest Baptist, conducted the study and presented the results. It was important to conduct the study because patients at large cancer centers may enter the health care system through “multiple intake processes, leading to delays in quality care,” she said.
Ms. Hyson explained that at her institution, patients entered the system through department-specific rather than disease-specific practices. She said this could lead to “delays from diagnosis to treatment,” which is significant because “timeliness to care is a priority in health care systems, particularly in cancer, and is used to evaluate and monitor quality of care.”
However, ONNs can “play a pivotal role” in the care of patients with cancer, as their knowledge provides patients with an “overall seamless experience,” Ms. Hyson said. This led her to create and evaluate a cancer concierge service to decrease the time from diagnosis to treatment and facilitate care coordination among multiple disciplines.
A consulting group was created for the cancer concierge service, consisting of ONNs, patient service coordinators, and health information coordinators. Under the cancer concierge service, new patient referrals were sent to the service through telecommunications or an electronic medical record work queue.
The patient service coordinator generated a brief patient summary based on a telephone encounter and sent the summary to a disease-specific ONN. Disease-specific ONNs reviewed encounter information, contacted patients, completed a formal assessment and provisional review, collected medical information, and assessed barriers to care.
The navigators provided the recommended multidisciplinary scheduling for patients using algorithms prepared by clinical practice groups, including providers from specific disease groups. The program also created an outreach encounter flowsheet to “capture the interaction and assessment between the patient and oncology nurse navigator,” Ms. Hyson said. Data from the program was collected for the calendar year 2022 through an electronic medical record system.
The new provisional review and cancer concierge service reduced the time between diagnosis and treatment from 35 to 30 days. The process also allowed ONNs to reduce patient contact times from 13 to 6 days after diagnosis. Expedited ONN referrals reduced the time from diagnosis to consultation by 4 days compared with patients not enrolled in the concierge service.
“Introducing oncology nurse navigators at the point of entry into a comprehensive cancer center provides for higher-quality coordinated care and facilitates multidisciplinary care leading to better overall patient experience,” Ms. Hyson concluded. “With provisional review, oncology nurse navigators practice at top of their license scope promoting clinical decision-making and tailoring a plan specific to each patient. Provisional review by oncology nurse navigators and coordinating multidisciplinary care decreased the time from diagnosis to treatment when compared to existing scheduling practices.”
Reference
Hyson, JS. Reducing diagnosis to treatment times through nurse navigation via a cancer concierge service. Presented at the Academy of Oncology Nurse & Patient Navigators 14th Annual Navigation & Survivorship Conference; November 15-19, 2023; San Antonio, Texas.
