Danelle Johnston, MSN, RN, HON-ONN-CG, OCN, and Tricia Strusowski, RN, MS, recapped their recent presentation from the ACCC 46th Annual Meeting & Cancer Center Business Summit, in which they discussed the National Evidence-Based Oncology Navigation Metrics: Multisite Exploratory Study to Demonstrate Value and Sustainability of Navigation Programs. The study was launched in June 2018 as a collaborative effort between the Academy of Oncology Nurse & Patient Navigators (AONN+), Chartis Oncology Solutions, and the American Cancer Society (ACS).
What were the objectives of the study?
The study evaluated the validity and reliability of 10 navigation metrics selected from a list of 35 evidence-based metrics developed by AONN+. The purpose of this multisite exploratory quality study was to implement and validate navigation metrics; identify common barriers and challenges to metric measurement, strategies for overcoming them, and measurement best practices and lessons learned; and develop a Navigation Metrics Implementation Toolkit based on study findings.
What were the 10 metrics selected for evaluation?
The selected metrics included 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 chosen metrics dovetail with the AONN+ certification domains in which navigators practice, as well as with national standards for which many institutions are already capturing data.
Who participated in the study?
We evaluated more than 60 applications and selected 8 academic and community institutions from across the country, including Abington Jefferson Health, Alan B. Pearson Regional Cancer Center, Capital Health Cancer Center, Harold Alfond Center for Cancer Care, Hollings Cancer Center, Rutgers Cancer Institute of New Jersey, UCHealth, and University of Arizona Cancer Center.
What was the methodology behind the study?
The study design involved a mixed-methods design, which collected quantitative and qualitative data focused on navigation metrics. Quantitative data assessing the validity of the 10 metrics were collected by each site using the NAVmetrics information technology platform. Qualitative data assessing challenges and successes in implementation were collected using key informant interviews, observation, and document review led by the ACS.
How can the data collected in the study influence navigation program development and best practices?
This study has provided a vehicle to spearhead national change in practice by using evidence-based national oncology navigation metrics. The data can be used to drive process improvement changes and quality cancer care, as well as to report best practices. The outcomes provide knowledge about the barriers and challenges navigation programs experience that impede data collection and reporting. This knowledge has been harnessed to create a Navigation Metrics Implementation Toolkit in collaboration with the ACS and AONN+. This research study is a vital, transforming event in the industry, with the desired outcome of providing validated measures to demonstrate the effect of oncology navigation on quality cancer care delivery, return on investment, private equity, and program sustainability.