The Thoracic Oncology Nurse Navigator and Using a Multidisciplinary Approach to Improve Timeliness of Care of Lung Cancer Patients in a Community Medical Center

November 2019 Vol 10, No 11
Kammi Fox-Kay, MSN, RN, AOCNS, ONN-CG(T)
Thoracic Oncology Nurse Navigator
University of Chicago Medicine
Chicago, Illinois
Karen Gersch, MD, FACS, FACC
Trident Medical Center,
Charleston, SC
Julia Saylors, MD
Trident Medical Center,
Charleston, SC
Yanis Bellil, MD
Trident Medical Center,
Charleston, SC
Angela Holten, BA, RRT-RCP
Trident Medical Center,
Charleston, SC
Sarah Weaver, BSN, RN
Trident Medical Center,
Charleston, SC

Background: Throughout a patient’s cancer care continuum, oncology nurses provide care as well as educational and emotional support to patients and families during a very difficult time. The most confusing and complex time is when patients are first diagnosed with their cancer. Multiple physician appointments and additional testing may follow. This may lead to a potential for fragmentation of care, delays in care, and lack of adherence to recommended treatment. Studies have shown that oncology nurse navigators (ONNs) play an integral role in cancer care and when added to a multidisciplinary team can increase timeliness of care from diagnosis to first treatment.

Objective: To increase timeliness of care from diagnosis to treatment for lung cancer patients at a community medical center.

Methods: After review of the 2017 cancer registry data at a community medical center, the healthcare system staff sought to improve the timeliness of care for lung cancer patients at their institution. In November 2018, a multidisciplinary thoracic work group was established to address barriers to timeliness in care for lung cancer patients. In addition, in July 2018, HCA Sarah Cannon instituted a system to notify the ONN of newly diagnosed lung cancer patients at the community medical center. The ONN would reach out to the newly diagnosed patient to establish a relationship and assist in coordination of care. The ONN was able to identify barriers to timeliness in care and address them. By working with the pulmonary medicine team as well as the thoracic surgeon office, the ONN was able to coordinate timely diagnostic testing and pulmonary assessments as well as coordinate between surgeon, medical oncology, and radiation oncology offices. The thoracic ONN was able to provide continuity of care and care coordination that led to more timeliness of care.

Results: Using tumor registry data for 2017, the average time from diagnosis to treatment was 41 days. Since July 2018, the average time from diagnosis to treatment has decreased to 31 days.

Conclusions: By creating a thoracic multidisciplinary approach to addressing patient’s barriers to timeliness to care, this community medical center has decreased the time from diagnosis to first treatment in lung cancer patients.

Resources

  1. Hunnibell LS, Rose MG, Connery DM, et al. Using nurse navigation to improve timeliness of lung cancer care at a Veterans Hospital. Clin J Oncol Nurs. 2012;16:29-36.
  2. Munoz RD, Farshidpour L, Chaudhary UB, Fathi AH. Multidisciplinary cancer care model. Clin J Oncol Nurs. 2018;22:141-145.
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