The Oncology Nurse Navigator’s Role in Enhancing the Multidisciplinary Cancer Conference at a Community Cancer Hospital

Background: The multidisciplinary cancer conference (MCC) plays an integral role in optimizing patient outcomes in today’s increasingly complex world of cancer care. MCCs offer multiple benefits, including increased use of evidence-based guidelines, consideration of all treatment options, and improved communication between team members. Despite their tremendous value, support for and utilization of MCCs in the community setting is not always optimal.

Objectives: Outline steps taken by the oncology nurse navigator (ONN) to help improve practitioner engagement and utilization of a community cancer center’s weekly MCC.

Methods: (1) An ONN coordinated a series of meetings to formally define goals/format of the hospital’s MCC. The MCC was changed from a general conference that discussed all types of cases to one that focuses exclusively on cancer cases. (2) The same expert ONN was dedicated to help coordinate the conference. (3) When submitting cases, the ONN asks presenters to identify specific questions about their case that they desire input about. The ONN also presents cases.

Results: A review of records was conducted that examined physician attendance and the number and type of cancer cases presented prior to (2015) and following (late 2016-2017) the implementation of the steps described above. Findings show that the number of cancer cases presented increased from 76 cases (2015) to 271 cases (2016) to 360 cases (projected 2017). The number of prospective cases also increased from 55% (2015) to 89% (2017). In 2017, a medical oncologist participated in conference 100% of the time compared with 14% of the time in 2015. In 2017, 82% of the time more than 1 medical oncologist attended conference compared with only 5% in 2015.

Conclusions: As cancer treatments become increasingly complex, community cancer centers must identify effective ways for fostering multidisciplinary care. The involvement of a skilled ONN in coordinating the hospital’s cancer-focused MCC can help meet this goal. The ONN is instrumental in carrying out the “behind the scenes” work that encourages physician engagement and increases prospective cases, such as reaching out to individual MDs to solicit cases, asking presenters to identify questions for which they are seeking input, and suggesting to MDs specific patients who would benefit from being presented at MCC. The ONN’s expertise allows her to provide comprehensive case preparation and instills confidence among presenters that they will have the material needed to properly present cases. The ONN offers valuable insight during conference and prompts presenters to consider NCCN guidelines. The ONN also builds MD engagement by making sure that what is discussed at the conference does not fall through the cracks. By serving as a presenter, the ONN enhances collegial interaction among the cancer team and fosters respect for her role. The fact that the ONN is so closely involved in MCC helps to strengthen the overall relationships between the cancer hospital and key physician team members, ultimately enhancing patient outcomes.

Source

Look Hong NJ, Gagliardi AR, Bronskill SE, et al. Multidisciplinary cancer conferences: exploring obstacles and facilitators to their implementation. J Oncol Pract. 2010;6:61-68.