October 2016 VOL 7, NO 9

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AONN+ Conference Abstracts, Research/Quality/Performance Improvement

Lay Navigation: A Quality Improvement Journey

Sonya Lovett 

Background: Oncology navigation has developed over the past several years into a necessary and critical component of cancer care as exemplified by the data available. As a result, cancer centers have assessed the prospect of becoming more efficient in the care provided to cancer patients. Lay navigation has become an avenue of providing quality cancer patient care. An Advisory Board Navigation Survey from 2014 of 144 cancer centers showed that 20% employ lay and clinical navigators. The majority of the lay navigators employed by the cancer centers are not cancer survivors.

Objective: To create a position for a lay navigator that will impact the quality of care of oncology patients across the continuum.

Methods: The initial phase of developing a lay navigator position was to benchmark and complete a literature search of the types of activities lay navigators perform at cancer centers. As cited in a 2014 Oncology Roundtable Navigation Survey, activities of lay navigators include accompany patients to physician office visits, administer psychosocial assessments, and connect patients to support services during and after an inpatient admission. Also, coordinate multidisciplinary conferences (MDCs), identify and help patients overcome barriers, provide written education materials, schedule patient appointments, support patients into survivorship, and track progress throughout diagnosis and treatment. As a result of the benchmarking, a dedicated lay navigator position was created in the Gibbs Cancer Center and Research Institute to assist in cancer screening events, educate patients, provide resources, and complete critical applications for financial resources for patients.

Results: The lay navigator promotes awareness through disease-specific screening events for the community. As a result of the community screening events, 150 people have received assistance from the lay navigator through Gibbs Cancer Center and Research Institute. The lay navigator also assists patients with applications for funding, Medicare, and SNAP benefits. This allows clinical navigators to meet and introduce patients to resources within the Gibbs Cancer Center. Additionally, the lay navigator is critical to the operation of the MDCs by organizing and gathering information to present newly diagnosed patients, and request any outside images and pathology for presentation at MDCs. In 2015, a total of 2136 cases were presented at a total of 336 disease-specific MDCs. The volume of paperwork and preparation is overwhelming. The presentation of each MDC case requires navigating the computer systems of radiology, medical oncology electronic documentation, and pathology. The lay navigator assists with the computer systems during each MDC.

Conclusion: Since the creation of the lay navigator position, all have benefited from the additional patient and professional assistance that the lay navigator has provided and continues to provide on a daily basis.

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