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June 2014 VOL 5, NO 3
The Future of AONN
Lisa A. Raedler, PhD, RPh
Memphis, TN—During the first day of the Fourth Annual Navigation and Survivorship Conference of the Academy of Oncology Nurse Navigators (AONN) in Memphis, Tennessee, the meeting co-chairs, Lillie D. Shockney, RN, BS, MAS, University Distinguished Service Associate Professor of Breast Cancer at Johns Hopkins University; Program Director of the Academy of Oncology Nurse & Patient Navigators (AONN+), and Sharon Gentry, RN, MSN, AOCN, CBCN, Breast Health Navigator, Derrick L. Davis Forsyth Regional Cancer Center, reviewed accomplishments and painted a compelling picture of the future of AONN+ as an organization.
Key Accomplishments in 2013
Lillie opened the presentation with a summary of AONN’s key accomplishments in 2013, including the following updated mission and vision statement:
Mission: The mission of AONN+ is to advance the role of patient navigation in cancer care and survivorship care planning by providing a network for collaboration and development of best practices for the improvement of patient access to care, evidence-based cancer treatment, and quality of life during and after cancer treatment. Cancer survivorship begins at the time of cancer diagnosis. One-on-one patient navigation should occur simultaneously with diagnosis and be proactive in minimizing the impact treatment can have on quality of life. Additionally, navigation should encompass community outreach to raise awareness targeted toward prevention and early diagnosis, and must encompass short-term survivorship care, including transitioning survivors efficiently and effectively under the care of their community providers.
Vision: The vision of AONN+ is to increase the role of and access to skilled and experienced oncology nurses and patient navigators so that all cancer patients may benefit from their guidance, insight, and personal advocacy.
Expanded AONN member benefits described include the AONN website, the Journal of Oncology Navigation & Survivorship, annual conference, webinars, local chapter support, and educational opportunities. The AONN website was enhanced to include educational resources and a community forum for idea exchange. “For you as navigators, the AONN website has a wealth of information that you can benefit from every day of the week, and every week of the year,” Lillie stated. In addition, Cancer Navigation News was launched. It is a timely and relevant newsletter delivered to AONN members every other week via e-mail.
The first in a series of AONN educational webinars was broadcasted, “Medication Nonadherence: Causes and Solutions,” which was hosted by Lillie. More than 400 individuals participated in this webinar. The second webinar in this series, which was conducted in December 2013, was hosted by Sharon, and was titled “Barriers and Obstacles Navigators Face in Oncology Navigation.”
Lillie also discussed the development of the AONN mobile application for smartphones, and explained that the new app allows users to view the AONN conference agenda, personalize their conference schedules, explore the exhibitor floor, learn the latest conference news, share experiences with fellow attendees using the Photo Gallery and Friends features, and rate AONN sessions and speakers.
Throughout 2013, AONN leadership updated and expanded AONN’s Strategic Business Plan, which includes the organization’s business objectives (ie, knowledge enrichment, networking opportunities, career development), and describes specific strategies and tactics to fulfill those objectives.
As she reviewed 2013 milestones, Lillie was thrilled to announce that AONN membership increased by more than 30% from 2012 to 2013. She recalled that when AONN started in 2009, approximately 100 people were members. Today, the association boasts more than 4000 members in every state of the United States and in every Canadian province.
Lillie also proudly summarized statistics documenting the evolution of the annual AONN conference (Table). The conference expanded significantly compared with 2012 in terms of attendees, as well as educational offerings. Lillie highlighted the provision of travel grants to 6 AONN members, as well as the gala event that was introduced during the November 2013 meeting. She invited all audience members to attend the Fifth Annual AONN+ Conference, which will be held September 18-21, 2014, at the Walt Disney World Dolphin Hotel in Orlando, Florida. When discussing the importance of information-sharing and networking at the annual conference, Lillie noted that AONN+ may also conduct regional meetings in the future.
Key Features of the Organization
After summarizing AONN’s activities and accomplishments for 2013, Lillie shifted to a review of key features of the organization, starting with the Leadership Council. She emphasized that each person on the council has unique expertise and leadership skills, as well as the role of determining AONN’s strategic direction and tactical offerings.
AONN currently has 1 committee, the Evidence into Practice Subcommittee, which is chaired by Elaine Sein, RN, BSN, OCN, CBCN. The goals of the committee are to provide ongoing education, support through mentoring, resources and tools, as well as avenues for discussion regarding outcomes, performance improvement, and the research process.
Lillie indicated that the Evidence into Practice Subcommittee conducted a knowledge assessment survey of AONN members in 2013, the results of which are summarized on the AONN website. Based on the survey findings, which indicated a need for additional training regarding research methods and reporting, the Evidence into Practice Subcommittee plans to provide education in the form of webinars, journal articles, and blogs on the Evidence into Practice community forum. The committee is also developing a mentorship program for navigators to receive one-on-one support with outcomes-based research projects on an as-needed basis.
A Closer Look at AONN Members
Lillie then provided a synopsis of the practice demographics of AONN members, as obtained through surveys of members (Figure 1). One-third of AONN members indicated that they specialize in breast cancer navigation. “This is probably not terribly surprising, since this is where oncology navigation began,” Lillie stated. Hematologic malignancy navigation and lung cancer navigation are also common specialties among AONN members.
When reviewing survey data regarding job titles, Lillie highlighted that the majority (68%) of AONN members are known as nurse navigators (Figure 2). Other titles included “manager,” “patient navigator,” and “case manager.” “I anticipate that we will see more and more people in ‘administrator,’ ‘supervisor,’ and ‘manager’ positions as more institutions expand their navigation programs,” Lillie predicted.
Lillie indicated that “patient navigators” may or may not be nurses; some are social workers, and others are lay navigators or cancer survivors. “It does not matter what someone is called. It is really more important that you know what you are supposed to be doing, and that you have the right tools and resources to do it.”
To conclude the survey data summary, Lillie stated, “Usually, an organization would need to be 8, 9, or 10 years old before it has reached this membership level. I hope that this means that AONN fulfills a need for you. We certainly want to continue to fulfill your needs, recognizing that, over time, your needs are going to change.”
Is “Navigator” a New Buzzword?
These survey data compelled questions from the audience regarding AONN’s plans to expand membership to include individuals who are involved with navigation, but who are not registered nurses. “We want this organization to not be limited to nurse navigators. It should meet the needs of all who are in the field of navigation, including lay or survivor navigators and social worker navigators,” Lillie responded. “We, as an organization, have had long discussions about fulfilling needs of navigators as a whole. AONN now says ‘nurse navigators,’ but we are looking to change it to say nurse & ‘patient’ navigators as well as add a plus sign to the end of that, so it will be AONN+. In this way, we show that the organization addresses the needs of all who are involved in the navigation process. Our flagship will always be nurse navigation, but we want to ensure that we are not leaving others out.”
Lillie admitted, and audience members verified, that the multiplicity of navigator titles (eg, caseworker, community outreach worker, case manager) causes significant confusion among healthcare professionals, as well as patients and family members. “It seems that ‘navigator’ has become a buzzword. Is someone who calls himself or herself a ‘faith-based navigator’ really a navigator? Or are they doing community outreach? We need to make sure that we know what we are doing, why, how, when, and with whom. And then we need to put all this to paper. Otherwise, it will never be clear. You do not want duplication of effort, and you do not want gaps in care. Documenting this for yourselves and your community is a really wise thing to do.”
Lillie observed that broadening the definition of oncology navigation professionals is particularly important as the number and scope of local AONN+ chapters expand. Professional networking, sharing of experiences and best practices, and collaborating on navigation-related research are optimized when all professionals who support cancer patients within a specific geographic vicinity are able to work together. At the time of the annual conference in November 2013, AONN had 2 local chapters, 1 in Arizona and 1 in North Texas. Today, AONN+ boasts 6 local chapters: Arizona, Kansas/Missouri, North Texas, Oklahoma City, Southwest Texas, and Upstate South Carolina.
Lillie concluded her portion of the presentation by recognizing the 6 travel grant recipients and bestowing the Third Annual Oncology Nursing Excellence (ONE) Award. The travel grants, which were sponsored by Daiichi-Sankyo, Genomic Health, Dendreon, and Onyx Pharmaceuticals, were awarded to navigators who submitted manuscripts to AONN+’s “Share Your Story” initiative. Each travel grant recipient described their experiences as navigators, including successes and challenges of their navigation programs. The 2013 travel grant winners included Libby Daniels, RN, OCN, Lexington Medical Center; LuAnn Roberson, RN, BSN, CBPN-IC, Assured Imaging; Laurie Rosa, BSN, RN, OCN, CBCN, CBPN-IC, Exeter Hospital Center for Breast Health; Joanne Smith, MSN, RN, CBHN, CMCN, Halifax Health Center for Oncology; Jan Tichenor, MSN, Medical City Dallas Hospital; and Sophia Yeung, BA, City of Hope.
Among approximately 100 nominees, Libby Daniels, RN, OCN, was selected as the winner of the ONE Award. Nominees for this award, which was sponsored by Bayer HealthCare and the Patient Access Network Foundation, are recommended by their peers because they have displayed leadership and compassion, as well as commitment to evidence-based practices in their navigation practices. The other 3 finalists for the award were Susan Scherer, RN, BSN, OCN, Tampa, Florida; Elizabeth Hatcher, RN, BSN, Washington, DC; and Anna Cathy Williams, RN, BSN, PHN, Duarte, California.
The Key Priorities of AONN+, Looking Ahead
Sharon then took the podium to unveil the future of AONN+. She described the group’s key priorities for 2014:
- Establishing AONN+ as the primary organization for navigation professionals
- Developing, endorsing, and promoting cutting-edge oncology navigation practice standards.
To achieve the first goal, AONN+ continues to expand educational opportunities, website resources, and printed materials for its membership. AONN+ also continues to collaborate with navigation leaders both throughout the United States and internationally, “reaching out to others to work with us.” Lillie’s visit with members of the Canadian organization, Community of Practice for Nurse Navigators, was highlighted as an example of AONN+’s international partnership and idea exchange.
Sharon concluded the presentation by highlighting 3 examples of oncology navigation “in the headlines” during 2013:
- Barriers to Breast and Colorectal Cancer Survivorship Care: Perceptions of Primary Care Physicians and Medical Oncologists in the United States
- American Cancer Society (April 12, 2013): The Effect of Nurse Navigation on Timeliness of Breast Cancer Care at an Academic Comprehensive Cancer Center
- Cable News Network (CNN) report (March 28, 2013): Helping Patients Navigate the Healthcare System.
Given the continuing evolution of the healthcare system, cancer patients’ increasing autonomy in decision-making, the plethora of new technologies and medications available to treat cancer, and universal challenges with cost and access to care, it is clearly an exciting and demanding time to be an oncology navigator. AONN+ leadership is committed to connecting, supporting, and educating nurses and other professionals who function in this role. The organization’s activities in the year 2014 have and will continue to sustain and shape navigators’ ability to optimize care for people with cancer.
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