AONN+ Metrics Team Measures Up

Background: Patient navigation has been shown to improve patient engagement and enrollment in clinical trials^1,2 and increase supportive cancer care.^3,4 However, oncology patient navigation is not universally provided⁵ or measured. A national subcommittee was formed by AONN+ in 2016 called the Navigation Metrics Subcommittee. One of the goals of the Navigation Metrics Subcommittee was to develop national evidence-based, standardized metrics in the areas of patient experience, clinical outcomes, and return on investment utilizing navigation core competencies, national guidelines, and value-based cancer care metrics to support our present healthcare landscape in oncology. As the committee evolved, the team also recognized the need to create, publish, and present navigation tools that support navigation metrics and the role of the navigator.

Objectives: To describe a novel AONN+ Navigation Metrics Subcommittee, including representation from all models of navigation designed to develop standardized metrics and supportive documents to facilitate quality, coordinated patient care, and financial stability for their institutions.

Methods: On a yearly basis, the Navigation Metrics Subcommittee develops and ranks goals to prioritize the work for the year. The goals are listed on the agendas, and new work teams are created to support the goals and report back to the committee. The following are the 2017 Navigation Metrics Subcommittee goals:

• Integrate value-based cancer care metric with AONN+ navigation metrics
• Create disease site–specific metrics
• Create an evidence-based navigation acuity tool
• Develop caseload benchmarks for navigation
• Create education fact sheet for providers/administrators on navigation
• Develop provider satisfaction survey
• Develop patient experience survey
• Provide guidance on implementing the AONN+ navigation metrics
• Create navigation orientation and annual competencies

Results and Goals Achieved in 2017

• The Navigation Metrics Subcommittee achieved the following goals:
• Published Navigation Metrics white paper and Source Document, February 2017
• Published Navigation Metrics article, April 2017
• Developed navigation orientation and annual competencies
• Created a provider fact sheet on navigation
• Created patient and provider navigation experience survey
• Published and presented education on value-based cancer care and metrics
• Published and presented results from a 2017 AONN+ breakout session on administrator engagement for navigation (42 attendees)
• Provided webinars/presentations on implementing the AONN+ 35 national evidence-based metrics at national conferences across the country
• Presented and published education on value-based cancer care and the AONN+ navigation metrics at national conferences across the country
• Published AONN+ Evidence-Based Oncology Navigation Metrics Crosswalk with National Oncology Standards and Indicators

Conclusions: Since inception, the Navigation Metrics Subcommittee has been highly productive as evidenced by the body of work presented here. Delivering quality products of this volume was possible due to the dedication of the experienced AONN+ leaders and team members of this subcommittee. Their commitment to furthering the development of the navigation role through standardization of metrics and creation of other practical tools has resulted in the achievement of the many goals set by this talented group. Additionally, their efforts to disseminate these tools and to educate all AONN+ members have led to a stronger, more unified and knowledgeable professional organization.

References

1. Guadagnolo BA, Dohan D, Raich P. Metrics for evaluating patient navigation during cancer diagnosis and treatment: crafting a policy-relevant research agenda for patient navigation in cancer care. Cancer. 2011;117(suppl):3565-3574.
2. Holmes DR, Major J, Lyonga DE, et al. Increasing minority patient participation in cancer clinical trials using oncology nurse navigation. Am J Surg. 2012;203:415-422.
3. Steinberg ML, Fremont A, Khan DC, et al. Lay patient navigator program implementation for equal access to cancer care and clinical trials: essential steps and initial challenges. Cancer. 2006;107:2669-2677.
4. Dohan D, Schrag D. Using navigators to improve care of underserved patients: current practices and approaches. Cancer. 2005;104:848-855.
5. Braun KL, Kagawa-Singer M, Holden AE, et al. Cancer patient navigator tasks across the cancer care continuum. J Health Care Poor Underserved. 2012;23:398-413.