December 2012 VOL 3, NO 6

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The Role Of The Administrator

Lisa Shalkowski, RN, BSN, MSM
Barbara Francks, RN, BSN, CBCN

Virtua’s breast care program strategy evolved from a fragmented process involving over 60 steps that resulted in random referrals, limited contact with patients, difficulty obtaining access to surgeons, and long cycles. The breast care program strategy that was developed was intended to create a personalized approach for patients and to follow a data-driven statistical problem-solving model (Design for Six Sigma) that included the following phases: define, measure, analyze, design, and verify. The definition phase included literature searches, defining best practices, and listening to the voice of the customer, ie, the patients and survivors with cancer, their caregivers, and physicians and their office managers.

Findings were obtained from focus groups and physician surveys. Project goals were established and included improving coordination of high-quality, compassionate care, providing a single consistent point of patient contact, timely delivery of services, improvement of patient satisfaction, and improved retention and referrals to Virtua’s physicians, programs, and services.

A pilot plan was implemented with 1 navigator in a large gynecology practice, and 2 half-time navigators in 2 physician practices over an 8-month time line. A major accomplishment was having the information technology staff create a specific database that could be used to track intake and surgery, assign a navigator, create a patient summary and reminders (task list), and be available as “view only” for physicians and support staff. Examples of the physician office referral, patient summary, task list, and reminder letter were shown. The surveillance/survivorship program includes follow-up, addressing late side effects, and establishing the navigator as a long-term resource. Virtua has increased its breast program and is launching programs in colorectal, thoracic, gynecologic, and prostate cancers.

Take-Home Messages

  • The administrator’s role includes interacting and communicating with the entire team and stakeholders, developing program goals, and proving the value of the program
  • Interaction between the administrator and navigators includes team and one-to-one communication, prompt problem solving, and recognition of navigator autonomy
  • A physician champion and physician buy-in are important
  • The navigator must foster physician relationships
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