Demonstrating the value of oncology patient navigation cannot be done without collecting metrics. At the recent AONN+ annual conference, a panel of navigators discussed the importance of tracking metrics in navigation programs, underscoring the need for return on investment (ROI), adherence, patient experience, and clinical outcomes data.
Moderator Brook Blackmore, MBA, MSN, BSN, RN, vice president of clinical operations at Azra AI, emphasized goals of the breakout session: for attendees to leave with actionable insights and the confidence to implement metrics into their navigation programs, and for each navigator in attendance to commit to capturing 1 new metric.
The panel, consisting of Stephanie Bonfilio, MSN, RN, OCN; Mary Rivera, MSN, RN, AOCNS; Morgan Nestingen, PhD, APRN, OCN; and Chris Gosselin, RN, MBA, each shared the most valuable (or personal favorite) metric captured in their own navigation programs, as well as insights on implementation of these metrics in other navigation settings.
“We hope to be able to equip you with the skills to get started on the next metric that you want to capture, and why,” said Ms Blackmore.
“By far, my favorite metric overall is timeliness of care,” said Ms Rivera, director of cancer services at Mount Nittany Medical Center in Pennsylvania.
Timeliness of care, measuring how quickly patients move from diagnosis to treatment, is universally acknowledged as a critical metric. It is objective, tangible, and widely applicable, making it an excellent starting point for navigation programs looking to collect metrics.
As Ms Rivera pointed out, patients diagnosed with cancer are acutely aware of time—time that will be affected by their disease going forward, as well as time related to their own mortality. Tracking this metric directly affects patient satisfaction and clinical outcomes, while at the same time identifying gaps in care and providing insights into where a navigation program stands.
“It’s a great metric to start off with, because you will really see a lot when you start to pull back the curtain and measure this,” she added.
According to Ms Bonfilio, oncology navigation manager at St. Elizabeth Healthcare in Kentucky, the most valuable metric in her program is measuring patient experience, particularly concerning navigation programs. At St. Elizabeth, a survey is sent out every 6 months to patients who are being navigated. The survey, which has a response rate of around 30%, consistently shows that over 95% of patients feel that having a nurse navigator enhances their overall experience. This feedback is crucial in providing qualitative data and demonstrating the value of navigation programs to higher-ups, she noted.
“Patients also leave tons of comments [on the surveys],” she said. “Having that voice of the patient is huge in being able to present to administration and senior leadership what we can do as navigators.”
Adherence is another essential metric, particularly in the context of ensuring patients follow through with recommended care plans, according to Dr Nestingen, director of nursing, patient intake, navigation, and access to care at Miami Cancer Institute.
“Whereas timeliness gives us the ‘when’ component, adherence gives us the ‘how’ component,” she said.
By tracking adherence, programs can determine if patients are completing necessary follow-up appointments and treatments, which is crucial for effective cancer management and better patient outcomes.
“My favorite metric to capture is ROI,” said Mr Gosselin, nurse manager of medical oncology at Mayo Clinic. Contrary to the perception that navigators are a cost burden, they actually generate significant savings and revenue for healthcare institutions. By ensuring that all necessary orders are placed and followed through, navigators help capture revenue that would otherwise be lost. For example, missing a CT scan or MRI can cost thousands of dollars, but having a navigator helps to ensure these orders are not overlooked.
Navigators also play a crucial role in reducing readmissions, another critical aspect of ROI. Oncology patients typically have a high readmission rate, but this rate drops significantly when patients are under the care of a navigator. By addressing issues early, navigators prevent complications that would lead to hospital readmissions, leading to substantial cost savings for the institution.
“Navigation—hand over fist—pays for itself,” Mr Gosselin said. “What we have found is that, on average, whatever salary you pay a navigator, you can recover about 1.5 to 2.5 times what you’re paying them.”
“Navigation—hand over fist—pays for itself,” he said. “What we have found is that, on average, whatever salary you pay a navigator, you can recover about 1.5 to 2.5 times what you’re paying them.”
For those new to collecting metrics, the advice from the panel is to start small. Begin with a single disease site or even a subset of patients. By focusing on a manageable group, programs can get their feet wet before gradually expanding to include more patients and metrics.
For example, tracking breast cancer patients who go on to surgery can be a good starting metric; from there, comparing navigated patients with non-navigated ones in that same subset can highlight differences in outcomes, advised Ms Blackmore. By starting small and gradually expanding, programs can develop robust metrics practices that enhance patient outcomes and ultimately demonstrate the value of navigation.
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