The Use of Patient and Provider Satisfaction as a Metric for the Effectiveness of the Oncology Nurse Navigator in an Academic Setting

Background: The role of the oncology nurse navigator (ONN) is expanding as the healthcare delivery system continues to change as it reacts to advances in cancer treatment and delivery, economic constraints, and increasing fragmentation that makes it difficult for consumers to navigate the healthcare system on their own. Metric studies looking at the role of the ONN have focused on timelines to treatment, but few have focused on patient and provider satisfaction as specific measures of the effectiveness of the ONN role and how it might impact patient perception of their healthcare delivery system.

Objective: To test the utility of patient and provider satisfaction as one of the metrics for measuring the effectiveness of the role of the ONN in an academic setting.

Methods: A total of 200 cancer patients who were identified by 3 ONNs as having received nurse navigation services over a 6-month period (August 2010-January 2011) were sent a letter and attached survey along with a self-addressed return envelope in February 2011. The survey consisted of 10 multiple choice questions and 5 short answer questions; patients were able to submit the survey anonymously. Returned surveys were mailed to an identified individual, and results were tabulated by a student from the Emory Business School. Thirty oncology providers (physicians, nurse practitioners, and/or physician assistants) who had the availability of ONNs in an academic-based clinic were surveyed from March through April 2012 utilizing surveymonkey.com. The survey consisted of 10 multiple choice questions and 5 short answer questions; providers were able to submit the survey anonymously. Results were tabulated by a student from the Emory Business School.

Results: Fifty-five responses were received from the 200 cancer patients contacted (26% rate of return). Individual ratings of agreement to statements about the care provided by the ONN with regard to knowledge, professionalism, information received, concern the ONN demonstrated, communication, emotional support, and an overall rating of the ONN program revealed a score greater than 90%. A surprising finding was that 67% of the patients agreed with the statement that the services of the ONN influenced their decision to obtain all of their cancer care at the academic medical setting. From the 30 oncology providers contacted, 29 survey responses were received (97% response rate). Statements about understanding the services provided to the patient by the ONN, the value of the ONN services to the practice, the timeliness of the coordination of patient care provided by the ONN, and the services of the ONN allowing the provider to offer a more comprehensive consult at the time of initial visit with the patient were all rated “strongly agree” by more than 60% of responders.

Conclusions: Patient satisfaction scores are a feasible metric for measuring the effectiveness of an ONN program in an academic medical center. Greater than 90% of the patients gave the ONN program an overall rating. Of the providers surveyed, 72% “highly agreed” that they were satisfied with the services provided by the ONN; the majority of these providers (70%) worked with the breast and gastrointestinal navigators exclusively. The results of the 2 surveys, although separate, provided baseline metrics to monitor over time as we continue to grow the ONN program at this academic medical center. The survey demonstrated that patients rated the services of the ONN higher than did the providers.