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June 2015 VOL 6 NO 3

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Evidence into Practice

How 7 Nurses Maximize Their AONN+ Membership—This Is Your Invitation to Join Our Evidence into Practice Subcommittee

Pam Goetz 

Seven Academy of Oncology Nurse & Patient Navigators (AONN+) members want you to know about a membership benefit that you might have overlooked. Everyone knows about the newsletter, the conference, and webinars that come with a membership, but did you know that there is a committee whose business is to help you do quality improvement projects and other forms of research, regardless of your level of experience in these areas?

Evidence into Practice Subcommittee is a committee within AONN+ whose purpose is to connect members who have never done quality improvement projects with those who have done formal research projects, as well as those with any other level of experience in between.

The Evidence into Practice Subcommittee wants to be sure that all AONN+ members are aware of how the committee can support them as a navigator. Participating in the committee has been working for your colleagues, and it may help you, too. We have interviewed 7 committee members about why they decided to get involved with Evidence into Practice Subcommittee.

The Evidence into Practice Subcommittee consists of 38 members who work in a variety of settings and share some common professional goals. At the core of the committee is the aim to improve how each of us provides care to our patients, and quality improvement helps us do that by measuring what we are doing, and using this information to determine ways to make processes and programs better.

From our conversations with committee members, a number of themes emerged relating to the benefits of being involved with Evidence into Practice Subcommittee. These include getting guidance in how to conduct quality improvement projects, how to write about quality improvement projects for presentations, learning about navigation best practices and evidence-based navigation, and how to prove your value as a navigator and justify your position on the healthcare team. Learning from others in the Evidence into Practice Subcommittee about best practices in navigation was a common theme among the nurses interviewed.

Sharing Best Practices

Barb McHale, RN, BS, OCN, CBCN, is a nurse with many years of experience working with patients with cancer, who has held positions as a case manager and in the public health setting. She is now a nurse navigator at Samaritan Hospital Cancer Treatment Center in Troy, NY. McHale has long understood the importance of following evidence-based standards of care, and finding ways to measure outcomes.

She has presented posters at the AONN+ conferences, winning first place in 2012 for a study looking at navigation and patient education for patients with head and neck cancers. She was invited to do a presentation at the advanced navigation track at the 2013 AONN+ conference in Memphis, TN.

In preparing for the talk, McHale received mentoring support from Evidence into Practice Subcommittee chairs Elaine Sein, RN, BSN, OCN, CBCN, who recently retired from Fox Chase Cancer Center, and Danelle Johnston, RN, MSN, OCN, CBCN, Manager of Breast Services at Memorial Hospital, University of Colorado Health. With their help, McHale refined her presentation, which described a project she undertook to improve patient access to rehabilitation services, using limited resources.

As McHale said, “The committee advocates for evidence-based practices, and working with the Evidence into Practice Subcommittee has offered me the opportunity to learn about and share best practices, not just follow trends in navigation.”

Mentorship, Paying Forward

Deb Christensen, RN, BSN, HNB-BC, navigates patients with hematologic and solid tumor cancers at the Intermountain Southwest Cancer Center in St. George, UT. She cares for patients from diagnosis through survivorship. She noted that the Evidence into Practice Subcommittee is a place where seasoned nurses, who have already been published, can help others with getting published.

Through mentorship, those new to research and quality improvement can glean skills from those with more experience; in turn, those mentored can use this knowledge to make their own contributions to the field of navigation. Christensen met with Elaine Sein for guidance with some research projects, and now views the committee as a resource that she can turn to for help in the future. Fortunately, Christensen’s institution supports her in doing research and in disseminating her results. To date, she has had 3 posters and an article published with the Journal of Oncology Navigation & Survivorship (JONS). One of her poster presentations was titled “Utilizing Metrics to Advance Navigation Services.”

Quality Improvement Tools

Nurses often do not have a lot of time to find the tools to carry out quality improvement projects and to report on their outcomes. Evidence into Practice Subcommittee can help navigators get a jump-start on their projects by offering resources, including metrics, data collection tools, needs assessments, how to design and complete a quality improvement project, and information on writing abstracts, designing posters, and writing research articles.

Marian E. Gilmore, RN, OCN, is a nurse navigator in a multispecialty clinic at Dana-Farber/Brigham and Women’s Cancer Center, in clinical affiliation with South Shore Hospital in South Weymouth, MA. Gilmore recognizes that the Evidence into Practice Subcommittee has helped her and others in identifying metrics that are meaningful to navigation, such as documenting the number of patients seen, how to track phone calls, and triaging patients.

In addition to learning about metrics, Gilmore has seen rewards by attending the AONN+ conference, where there are opportunities to acquire great information, get help with program development, and learn about quality improvement, specifically in a surgical setting. Gilmore is willing to help others with surgical navigation and quality improvement, as this is the area she supports patients pre- and posttreatment.

Frances M. Johnson, MSN, RN, AOCN, ANP-BC, CNS, is a Primary Care Triage Nurse at Michael E. DeBakey Veterans Affairs Medical Center in Houston, TX. She is also working on her dissertation, which focuses on the role of nurse practitioners in oncology navigation. Johnson has been motivated to be involved with Evidence into Practice Subcommittee to help with defining metrics, which will progress the field of nursing and navigation.

Nikki Levinson-Lustgarten, RN, BSN, CBPN-IC, works as a breast care coordinator at Navy Medical in Jacksonville, FL, the fourth largest Navy hospital in the system, which is the equivalent of a community hospital. They have surgical capabilities, and use community resources for hematology oncology and radiation oncology.

Levinson-Lustgarten’s interest in Evidence into Practice Subcommittee stems from her recognizing that it is important to do quality improvement activities relative to processes and data, which will be important in stating a case for hiring another navigator. Because of her work schedule, Levinson-Lustgarten has yet to call on the group to help her achieve her goals, but has a number of projects that she hopes to pursue with Evidence into Practice Subcommittee. In particular, she is interested in producing a patient satisfaction survey, and sees Evidence into Practice Subcommittee as a resource to get this accomplished.

Levinson-Lustgarten will also look to the committee for guidance in creating a database for tracking her patients, who receive some of their care at Navy Medical, and the remainder of their care is delivered in the community, which presents a challenge for many navigators. We all have limited resources in our own institutions, and Evidence into Practice Subcommittee is here to supplement and fill any informational needs.

Advancing the Navigation Role—Locally and at the National Level

Most of the navigators interviewed stated that quality improvement is important to them for the purpose of advancing their navigation role at the local and national level. Whether to argue the case for keeping an existing navigator position or justifying the need for an additional navigator, data collection and quality improvement projects are seen as necessary by many navigators.

Carrie Stricker, PhD, RN, is a nurse practitioner and Director of Clinical Programs at Abramson Survivorship Center at the University of Pennsylvania, and is an adjunct faculty member in nursing. She wanted to document value to garner administrative support for program activities, so she uses data collection and quality improvement projects to help achieve this goal. Dr Stricker said, “Nurses and others don’t have one place to go for research support, and there is no one answer or agreement on what data to collect.”

Most nurses have not learned how to do evaluation work in their formal training, learning on the job with a mentor; therefore, networking in a professional organization, and taking learning opportunities via webinars or through mentorship in a committee like Evidence into Practice Subcommittee, can help fill this gap. Dr Stricker sees the value of being involved with Evidence into Practice Subcommittee as having an impact in the field of navigation at the national level, and wants to contribute to discussions with others on the committee and to take information back to her team.

Furthermore, Dr Stricker noted that patients with cancer have choices on where to go for their treatment, and the level of professionalism that a navigator offers can help draw patients to cancer care centers. The new Commission on Cancer mandates, when translated into practice, require cancer centers to collect data to show what a cancer program has done, and how the program addressed an identified need and made a difference to patients.

Britta Newcomer, RN, BSN, OCN, has an administrative role at Catholic Health Initiatives in the National Oncology Service Line in Denver, CO, which covers 45 cancer care centers. As a clinical quality specialist, Newcomer oversees 10 to 12 navigators who provide navigation, outreach, and survivorship care. Newcomer’s interest in the Evidence into Practice Subcommittee is in contributing to discussions about navigation at the national level, as well as taking pertinent information back to her team. In particular, she felt that Elaine Sein’s presentation on standardizing navigation metrics was timely for her team. Newcomer is grateful to be a part of Evidence into Practice Subcommittee and all it has to offer her, as well as the navigators she works with directly.

If any of these themes have struck a chord with you, do not hesitate to get involved with Evidence into Practice Subcommittee. There are many different ways that you can participate, whether you want to learn from the other committee members or the general AONN+ community, or if you want to share information with others.

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