Background: Sylvester Comprehensive Cancer Center (SCCC) at the University of Miami is 1 of only 2 cancer centers that have been recognized by the National Cancer Institute in Florida. The nurse navigation department services more than 20,000 new patients a year across 1 main campus and 8 satellite locations. Input from the Patient and Family Advisory Council indicated the need for increased visibility of nurse navigation services to the community. Additionally, SCCC had a 35% cancelled or no-show rate in 2019. Development of an on-demand nursing program was proposed to improve retention rates and better service new cancer patients.
Objectives: To improve the experience of patients by offering scheduled video or phone appointments with a nurse navigator within 24 hours of calling the center for an initial appointment, a pilot program, named Sylvester Oncology On-Demand Nursing (SOON), was developed and implemented.
Methods: In November 2019, a task force was assembled to operationalize the development of the SOON program. Information technology developed a nonbillable nursing schedule template and visit type to be utilized in the Epic electronic medical record. Training, education, and scripting were developed and implemented for call center representatives scheduling SOON appointments. The SOON pilot program began in May 2020 with 1 nurse navigator. Patients with confirmed gastrointestinal malignancies were offered an additional telehealth visit with a nurse navigator within 24 hours of their initial call to the cancer center or according to their preference.
Results: Since implementation of the SOON program, 18 visits within 3 months were scheduled with the nurse navigator. A patient satisfaction survey found that 100% of patients strongly agreed that the nurse navigator provided them with helpful information, and 100% also strongly agreed the nurse navigator answered questions in a manner they could easily understand. In addition, 83.3% of patients strongly agreed and 16.7% agree that the support they received helped decrease their anxiety. One hundred percent of patients valued being able to schedule an appointment with the nurse navigator.
Conclusions: The SOON program allows patients to schedule appointments within 24 hours of their initial call to the cancer center with a nurse navigator to address concerns via video or phone appointment. This has proved to assist and meet the needs of patients during the COVID-19 pandemic and provide patient coordination and personalized care. Additionally, the experience allows the nurse navigator to gather relevant information well in advance of the new patient visit. The nurse navigator has also reported increased job satisfaction due to increased face-to-face communication with the patient and family members via video appointment. SCCC plans to expand the SOON program to other cancer site–specific groups within the current and upcoming year and further analyze the impact of the program as it relates to cancellation rates.
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