Objectives: 1) To improve understanding and completion of a CNA driven by Standard 3.1 Patient Navigation by the American College of Surgeons Commission on Cancer at the Louis Stokes Cleveland Veterans Affairs Medical Center (LSCVAMC); and 2) to incorporate patient and staff input into development and implementation of the CNA.
Methods: A CNA form was selected to initiate screening for Standard 3.1 Patient Navigation. The CNA was distributed and completed by 50 veterans from February 2014 to September 2014. During the survey completion, input from veterans and staff assisting in completion of the CNA reported the form was complex and difficult to fill out. The CNA questionnaire was reviewed by an interdisciplinary group consisting of an oncology social worker, oncology psychologist, medical oncologist, survivorship advanced practice nurse, 3 oncology nurse care coordinators, and the cancer center program administrator. The questionnaire was reformatted due to the complexity of the form and decreased readability reported by those completing the forms. The original CNA consisted of 2 pages, with each area scored on a Likert scale. The reformatted CNA was presented to the Cancer Committee for review and approval. The revised CNA is currently being disseminated and completed by veterans in the infusion clinic and will also be disseminated at the upcoming LSCVAMC Cancer Fair.
Results: The CNA continues to cover all 4 spheres of physical, social/practical, emotional, and spiritual/religious areas. The CNA was reformatted, increasing the font size and decreasing the length to 1 side of the paper instead of 2. The Likert scale was removed and replaced with a yes/no nominal scale. Travel was added to the needs assessment in addition to system-specific questions. Future review of the new CNA will be with the Patient Education Resource Center to improve health literacy. More specific data regarding community needs are forthcoming and will be presented at the conference.
Conclusions: The CNA will allow the LSCVAMC to identify barriers to cancer care and potential areas for improvement to ensure continuous quality improvement and access for our veterans with cancer.