Background: Oncology nurse navigation continues to grow in importance as nurses assist with the diverse needs of the oncology patient population. In 2015 the American College of Surgeons Commission on Cancer will require a navigation program at all cancer centers to obtain accreditation. At the Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (The James), a 205-bed comprehensive cancer center located in the Midwest, navigation was explored reflecting the relationship-based care nursing model. Roles within The James provide aspects of the navigation function, without the full impact a designated role could demonstrate. Complex care needs within a diverse, multisite healthcare system require a concerted effort to coordinate care with best practice outcomes
Objectives: To develop a nurse navigation program that will address barriers and identify available resources, improving timely access and ease across the continuum of care. Oncology patients deserve the opportunity to work with a navigator who has the education and expertise to coordinate their complicated care needs.
Methods: Utilizing the patient-centered relationship-based care model as a framework, a group of nurses functioning in a care-coordination role formed a work group and completed the following: literature review and conference attendance for knowledge; survey of patients, families, advisory groups for gaps in experience; local market and National Cancer Institute competitive assessment; review of tracking and outcome software.
Results: The job description was drafted, a pilot study of the nurse navigator role was approved, and the first nurse navigator was put in place. Existing roles are currently being evaluated, actively identifying barriers, and the work group is systematically addressing these, as the role develops, to ensure the effective use of the navigator, allowing for the expansion of the program.
Conclusions: Analysis of current care coordination demonstrates many resources are available, yet consistent implementation of access to care and services would add value to the organization. Education and reallocation of staff to meet new role expectations is being explored to maintain a budget-neutral program implementation. Software design is in process and a research study has been proposed to evaluate the effectiveness and outcomes of patient navigation. The successful implementation will include the designation of a disease management expert accessible to patients and providers to expand resources, increase patient compliance, and ease care burden.