Background: With clinic space becoming a premium at the University of Arizona Cancer Center (UACC), oncology nurse navigators (ONNs) sought an alternative method to connect with all newly diagnosed patients for a time period that was sufficient to introduce the navigation process and conduct a barrier assessment. A pre-visit assessment phone call was a possible solution, but it was unknown if new patients would accept such a call or find it valuable. Additionally, the UACC leadership directed ONNs to focus on increasing access to care and assist in marketing the center. ONNs wanted to know if a pre-visit phone contact would help patients to solidify their decision to seek care at UACC. Experts from the Academy of Oncology Nurse & Patient Navigators1 and the Oncology Nursing Society2 include conducting a barrier assessment as a key function of an ONN. Currently, however, there are no published studies about conducting a barrier assessment over the phone prior to a newly diagnosed patient’s first visit with an oncologist.
Objective: To determine the perceptions of newly diagnosed cancer patients about the value and acceptance of pre-visit assessment phone calls from ONNs.
Methods: A script was created to facilitate “cold calling” patients scheduled for their first oncology appointment. During the call, the ONN introduced herself, the ONN role, and the purpose of the call. Navigation services were offered, and the patient was given the option to decline the phone call. Questions to elicit information about barriers to care were asked in a conversational manner. Information about what to expect at the first visit was provided, and patients were able to ask questions. At the first appointment, patients were given a questionnaire and asked to complete it before leaving the clinic. The survey asked 3 “Yes or No” questions, and a request for comments/suggestions was included.
Results: The survey period was 16 weeks, and 7 disease-site ONNs participated. In total, 244 surveys were given out, and 169 were returned, a 69% response rate. All patients accepted the phone assessment process. An overwhelming majority of respondents found both the assessment questions asked (95%) and the information provided (97%) during the phone call to be helpful. When asked if the phone call helped to influence their decision to receive care at UACC, 64% responded affirmatively, 19% responded that it did not have an effect, 8% had no opinion, and 9% did not answer. Examples of typical comments included: “Appreciated her phone call ahead of time.” “This phone call allowed me to be calm.” “Navigator call relieved anxiety.” “Was so nice to receive call prior to appt.”
Conclusion/Implications for Practice: The perceptions of newly diagnosed patients conveyed in this survey demonstrated positive value and acceptance of pre-visit barrier assessment phone calls. One implication for navigation is that ONNs who practice remotely, serve large spread-out systems, or have space limitations may consider a pre-visit phone assessment as an option.
- Strusowski T, Sein E, Johnston D. Standardized evidenced-based oncology navigation metrics for all models: a powerful tool in assessing value and impact of navigation programs. Journal of Oncology Navigation & Survivorship. 2017;8(5):220-237.
- McMullen L, Christensen D, Haylock P, et al. 2017 Oncology Nurse Navigator Core Competencies. https://dev-www.ons.org/sites/default/files/2017-05/2017_Oncology_Nurse_Navigator_Competencies.pdf 2017.