December 2012 VOL 3, NO 6

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Gastrointestinal and Colorectal Cancer Navigation

Maura Kadan, RN, MSN, OCN

Ms Matten observed that thoracic oncology navigation is in its infancy, and thoracic oncology navigators are therefore in the position of being able to develop evidence-based practice models. She discussed how those who are novices in the field can develop into expert navigators by gaining experience, developing skills, and understanding patient care after achieving a sound educational base. The National Cancer Institute Community Cancer Centers Program (NCCCP; is a network of community hospitals throughout the United States that support cancer research and enhance cancer care. The NCCCP Quality of Care subcommittee developed the Navigation Matrix Tool, which can be used to build or advance a navigation program, and contains categories representing every component of navigation that programs should contain.

Ms Matten described the thoracic oncology program matrix tool that can be used to assess thoracic navigation programs based on the NCCCP Navigation Matrix and her more than 8 years of experience as a thoracic oncology nurse navigator.

The areas of evaluation include team development, strategic planning, marketing, patients navigated, and multidisciplinary conference participation. Team development includes assigning a program medical director and educating primary care physicians on the referral process. Strategic planning includes developing a formal business plan for the program and keeping it updated. Marketing activities include educating primary care physicians in a variety of settings, developing brochures and yearly update letters, developing a program Web site, and forming community partnerships such as participation at health fairs. Patients for navigation are identified through pathology reports. Multidisciplinary conference participation involves presenting patients at general cancer and thoracic-specific oncology conferences. The navigator’s role includes identifying patients to present, following up about recommendations with patients and/or their physicians, and developing a formal written report on the treatment plan to be shared with the patient and physicians. Other thoracic oncology navigator program activities include measuring and evaluating outcomes, educating patients about clinical trial participation, initiating and marketing screening programs, eg, a lung CT screening program; education about prevention, eg, smoking cessation; referrals to support group and pulmonary rehabilitation programs (where available—if they are not, advocacy for these programs may be required), and providing surveillance and survivorship information and care plans.

Take-Home Messages

  • • Thoracic oncology navigation is a developing area and provides navigators with the opportunity to build evidence-based practice models
    • The NCCCP Navigation Matrix Tool can be used to build or advance a navigation program and provides a way to achieve benchmark status

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