CRANBURY, NJ—Patient navigation for individuals with cancer first caught on in the 1990s and quickly gained traction with patients, clinicians, and cancer programs alike. However, shifts in healthcare policy and funding over the past decade have put many navigation programs to the test as practitioners struggle to quantify the value of their services in terms of patient outcomes and their employer’s bottom line.
The Academy of Oncology Nurse & Patient Navigators (AONN+), the largest national specialty organization serving oncology nurse and patient navigators, is working to address this challenge through the launch of a national, multisite study aimed at answering key navigation questions.
The study, “National Evidence-Based Oncology Navigation Metrics: Multisite Exploratory Study to Demonstrate Value and Sustainability of Navigation Programs,”is a collaboration among AONN+, Chartis Oncology Solutions, LLC, and the American Cancer Society* that will evaluate the validity and reliability of 10 navigation metrics selected from a list of 35 evidence-based metrics developed by AONN+. The selected metrics include barriers to care; time from diagnosis to initial treatment; navigation caseload; number of navigated patients readmitted to the hospital at 30, 60, and 90 days; psychosocial distress screening; social support referrals; palliative care referrals; identifying patient learning-style preference; navigation knowledge at time of orientation; and patient experience/ satisfaction with care. The study will also provide insight into the barriers and challenges that navigation programs encounter when implementing navigation metrics.
“By standardizing metrics under the AONN+ domains, navigators can measure the impact they have with patients from initial diagnosis to survivorship and end of life,” says AONN+’s Danelle Johnston, MSN, RN, ONN-CG, OCN, Chief Nursing Officer and Senior Director of Strategic Planning and Initiatives, and study co-principal investigator. “These metrics are designed to be used by all organizations and programs to demonstrate the efficacy and sustainability of their programs. They will also assist in measuring outmigration and retention of patients, downstream revenue within the system, increase in screening procedures, reduction in hospital readmissions, decrease in no-show rates, and increase in referrals to revenue-generating services within the organization.”
Recruitment began in March 2018 and by June, 8 study sites had been selected, trained, and institutional review board approved for participation. Data collection began at the following locations on November 1, and will extend over 6 months:
- Abington-Jefferson Health, Asplundh Cancer Pavilion, Abington, PA
- Centra Health, Alan B. Pearson Regional Cancer Center, Lynchburg, VA
- MaineGeneral Health, Harold Alfond Center for Cancer Care, Augusta, ME
- Medical University of South Carolina, Hollings Cancer Center, Charleston, SC
- Rutgers Health, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ
- Capital Health Cancer Center, Trenton, NJ
- University of Arizona Cancer Center, Phoenix, AZ
- University of Colorado Health, Fort Collins, CO
“As they test these metrics, we will collect qualitative data on the barriers and challenges the pilot sites face in metrics implementation, data collection, analytics, and reporting,” says Lesley Watson, PhD, study co-principal investigator and Principal Scientist in the Statistics and Evaluation Center at the American Cancer Society. “These data will help us in our collaboration with AONN+ to produce an implementation toolkit, which other sites may use to support their efforts to track navigation metrics. By developing tools to facilitate the collection of metrics, we can contribute to the evidence-base around oncology navigation.”
For its part, Chartis Oncology Solutions will provide data capture, management, and analytics reporting of the 10 navigation metrics implemented at each study site through NAVmetrics™, a cloud-based tool powered by Chartis Oncology Solutions’ ONC iQ® business intelligence platform.
“Working with national study participants and more broadly with navigation programs across the country, Chartis Oncology Solutions recognizes the challenges navigators face with collecting and reporting data in a standardized way,” says Kelley D. Simpson, MBA, Director, Chartis Oncology Solutions. “By extension, many are not leveraging the existing EHR data systems in place to complement the work they are doing. Whether they face data entry, extraction or tracking hurdles, the national study and introduction of the NAVmetrics™ tool is assisting study sites with more easily accessing the data needed to populate the 10 core metrics for meaningful outcomes reporting.”
Preliminary findings of the study will be presented at the AONN+ Midyear Meeting in May 2019. For more information, please visit www.aonnonline.org/education/standardized-metrics/navigation-metrics-quality-study.
*This project is partially funded through a grant from the Merck Foundation and is part of the American Cancer Society’s Patient and Caregiver Services Unit’s Care Coordination and Patient Navigation Program. Information about the Merck Foundation and this grant can be found at www.msdresponsibility.com/our-giving/foundation/.
About the Academy of Oncology Nurse & Patient Navigators® (www.aonnonline.org)
The Academy of Oncology Nurse & Patient Navigators, Inc. (AONN+) is the largest national specialty organization dedicated to improving patient care and quality of life by defining, enhancing, and promoting the role of oncology nurses and patient navigators. The organization, which has more than 8200 members, was founded in 2009 to provide a network for all professionals involved and interested in patient navigation and survivorship care services in order to better manage the complexities of the cancer treatment process.
The Journal of Oncology Navigation & Survivorship®(www.jons-online.com) is the official publication of AONN+. It is published 12 times a year and features topics related to patient navigation and survivorship care. The Journal of Oncology Navigation & Survivorship offers original research, best practices, interviews, case reports, and study highlights, as well as a platform through which navigators can share research and views on navigation and survivorship issues.
CONQUER: the patient voice®magazine (www.conquer-magazine.com) is the AONN+ premier forum for patients with cancer. CONQUER features articles written by and for patients with cancer, survivors, nurse navigators, and other oncology team members. This magazine addresses the issues that patients, their family members, and caregivers face every day in an easy-to-read format. Issues include interviews with patients with cancer, information on access to care, and articles on lifestyle topics such as nutrition, stress management, personal finance, and legal and employer issues. CONQUER also features patient stories that are nominated for the AONN+ Hero of Hope™ Patient Award, which is presented at the AONN+ Annual Conference. All stories are compiled in a special issue of CONQUER at the end of the year.
Chartis Oncology Solutions (www.oncologysolutions.com)
Chartis Oncology Solutions (COS) was established in January 2018 when Oncology Solutions joined The Chartis Group, a comprehensive healthcare advisory and analytics firm. COS offers preeminent cancer care advisory and analytics services to community hospitals, health systems, and NCI-designated and academic cancer centers across the country. With unparalleled depth of expertise and experience, COS works collaboratively with healthcare professionals to strategically and operationally implement cancer care programs that enhance patient experience, improve provider performance, and impact communities. Oncology Solutions was founded in 1973 as the first firm exclusively dedicated to serving cancer providers.
American Cancer Society (www.cancer.org)
The American Cancer Society is a global grassroots force of 1.5 million volunteers saving lives in every community. As the largest voluntary health organization, the Society’s efforts have contributed to a 25% decline in the cancer death rate in the United States since 1991, driven by less smoking, better treatments, and earlier detection. We’re finding cures as the nation’s largest private, not-for-profit investor in cancer research, ensuring people facing cancer have the help they need and continuing the fight for access to quality healthcare, lifesaving screenings, and more. For more information, to get help, or to join the fight, call us anytime, day or night, at 800-227-2345 or visit cancer.org.