Navigation Acuity Tool; Scoping Review

Background: Tools that help to characterize patient acuity have been used in healthcare for decades and have proved successful as a means of determining staffing needs, improving patient care, and controlling costs. In fact, a wide array of navigation acuity tools used for a variety of different purposes exist, but there has been little nursing research into the validity and reliability of these tools. Currently, despite an acute need and the efforts of individual institutions, there is not a standardized, validated, evidence-based navigation acuity tool available for oncology navigation programs.

Objectives: To investigate and analyze articles related to components of the oncology navigation acuity tool, including age, race, ethnicity, diagnosis and stage, barriers, and treatment per National Comprehensive Cancer Network (NCCN) guidelines or other national standards published from January 1, 2018, to April 1, 2021. These articles will be used to provide for the development of evidence-based oncology case studies. The case studies will be used as part of a feasibility study to test the navigation-specific acuity tool. The tool is expected to help oncology navigators characterize the complexity of their patients, aid in the allocation of navigation resources, and measure the effectiveness of navigation on patient outcomes.

Methods: This scoping review considered all studies that addressed age, race, ethnicity, diagnosis and stage, barriers, and treatment per NCCN guidelines or other national standards. A 3-step search strategy was used: (1) initial limited search of PubMed, (2) extensive search using all keywords and index terms, and (3) hand search of the reference lists of included articles. This review was limited to studies published in English from January 1, 2018, to April 1, 2020. Reviewers extracted data independently; disagreements that arose between the reviewers were resolved via discussion, or with a third reviewer.

Results: Findings from the review and analysis of relevant articles, using the PRISMA model, identified a total of 1764 articles were screened, 555 full text publications were reviewed, and 49 relevant articles were identified. A total of 2 studies used a quantitative design, and 38 used a qualitative design. The sample size used for analysis in quantitative and qualitative designs ranged from n = 1 (case report) to 278,936 (retrospective database study), and 9 used review or systematic review methodology. The majority of the analyzed studies were implemented in oncology settings or from population- or registry-based samples. Most studies focused on physical well-being. Studies focused on age, race, ethnicity, diagnosis and stage, barriers, and treatment for the case studies used to support the feasibility testing of the acuity tool.

Conclusion: Inclusion of these case studies will be beneficial for developing an evidence-based navigation-specific acuity tool that is expected to help oncology navigators characterize the complexity of their patients, aid in the allocation of navigation resources, and measure the effectiveness of navigation on patient outcomes.

Source

Johnston D, Strusowski T, Messier N, Willhite L. National AONN+ initiative in collaboration with Astellas: unlocking navigation acuity. Journal of Oncology Navigation & Survivorship. 2019;10(10):406-412.