Debbie Bickes MN RN OCN Supervisor Oncology Patient Navigation Northside Hospital Cancer Institute Objectives Explain oncology patient navigation Provide a brief description of the history and evolution of oncology patient navigation ID: 1034704
Download Presentation The PPT/PDF document "Oncology Patient Navigation Overview" is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
1. Oncology Patient Navigation OverviewDebbie Bickes, MN, RN, OCN®Supervisor, Oncology Patient NavigationNorthside Hospital Cancer Institute
2. ObjectivesExplain oncology patient navigationProvide a brief description of the history and evolution of oncology patient navigationDifferentiate between oncology patient navigation rolesDescribe the Oncology Patient Navigation Program at Northside Hospital Cancer Institute (NHCI)Discuss ways in which oncology patient navigators may assist patients and caregivers2
3. Your Life Changes Forever withThree Words…“You have cancer.”Cancer does not discriminateA diagnosis often leads to a high level of anxiety, fear and uncertainty, a sense of helplessness, feeling overwhelmed and lostCancer is a complex diseasePatients often see multiple physicians to determine a treatment planMedical terminology can be quite confusing and hard to understandPatients are not always comfortable asking their physicians to explain, or they may be overwhelmed with information and have questions after their visit3
4. 4
5. What is Oncology Patient Navigation ?“Individualized assistance offered to patients, families, and caregivers to help overcome healthcare system barriers and facilitate timely access to quality health and psychosocial care from pre-diagnosis through all phases of the cancer experience” (ONS, AOSW, NASW, 2010)5
6. Dr. Harold Freeman’s Contributions to Oncology Patient NavigationSurgeon in Harlem (1967)President of the American Cancer Society (1988 – 1989)Developed an approach to address the heavier burden of disease in the low-income population that he servedEstablished the Harlem Patient Navigation Program in 1990 designed to reduce disparities in access to health care“I was really raring to go out and do what I could, but this was somewhat of a shock to me—having been trained to do all this cancer work, and then I’m facing late-stage cancer that is too late for me to be effective technically.” – Harold Freeman, M.D.The “Founding Father” of Oncology Patient Navigation6
7. Dr. Freeman’s Navigation ProgramConsisted of navigators who were from the community or who were culturally similar to the population servedThe navigators were trained in the clinical care pathway that the patient should follow in order to complete care Freeman’s navigation program was able to demonstrate a reduction in racial, ethnic, and poverty-driven disparities in careOver time, the role of the oncology patient navigator evolved and expanded to assist people from all socioeconomic backgrounds, following them along the continuum of care 7
8. Roles in Oncology Patient NavigationProfessional NavigatorOncology Nurse NavigatorOncology Social WorkerNon-Clinically Licensed (Lay) NavigatorNon-clinically licensed person with specialized training8
9. 9
10. Northside Hospital Cancer Institute Oncology Patient Navigation ProgramDefinitionAn Oncology Support Service that uses a person-centered approach in collaborating with patients, families and caregivers as they negotiate the maze of treatments, services and potential barriers through their care.Mission To guide patients, families and caregivers to informed decision making; collaborating with multi-disciplinary teams to help overcome health system barriers creating timely cancer screening, diagnosis, treatment and supportive care across the continuum of cancer care. VisionEvery Northside Hospital Cancer Institute patient, family and caregiver has access to navigation services throughout the cancer continuum. 10
11. Main Concepts of Oncology PatientNavigation at NHCI 1. Person-Centered CareCharacteristicsCoordinating CareAppropriateContinuousRespectListening to and respecting a person’s values and preferencesEducationEmotional SupportCommunicationMultidisciplinary teamFamily and friends11
12. 2. Assist with Barriers to CareBarriers to care may include, but are not limited to:Informational: Understanding diagnosis, disease, tests, treatments and medical termsSocial: Support system, cultural beliefsPractical: Problems with activities of daily living, child, pet or elder care, finances and bills, housing, food and clothing, supplies, transportation, living conditions, languagePhysical: Disability, fatigue, insomnia, nutrition, fertilityEmotional: Fear, loss of control, copingPsychological: Body image disturbanceSpiritual: Spiritual distress12
13. 3. Continuum of CareNavigation
14. Oncology Nurse Navigator (ONN)Registered nurse with specialized training in a disease siteServes as a resource for patients across the continuum of carePatient Education: Helps explain terminology and concepts related to a specific cancer diagnosisCommunication and Coordination: Assists to facilitate communication and connections between patients and members of the healthcare teamPoint of Contact: Serves as a point of contact for patients unsure of next steps in their careCancer Care Liaison (CCL)Non-licensed person with training in non-clinical careFacilitates ResourcesIdentifies and links patients and caregivers to resources individualized according to their specific needsNHCI Oncology Patient Navigation Team14
15. Who is Navigated at NHCI?Patient navigation is available to all patients receiving cancer treatment at NHCIReferrals come fromPhysiciansNursesSocial workersHealthcare staffMultidisciplinary conferencePatient self-referral15
16. Navigation of Patients 16
17. 17Hawkinsville & Milledgeville, CCLJacoby HallCancer Care Liaison(CCL)Oncology Nurse Navigator(ONN)Kennestone, CCLSamantha WilliamsPaulding & Cobb , CCLAmy BeardenCanton CCLKatie MullinixMacon, CCLJennifer PittardAlpharetta, ONNClare SchuylerForsyth, ONNLisa Decker Atlanta, CCL/OtherMegan WhittingtonLauren McKee, ACSAtlantaSupervisorsDebbie BickesKeisha JenningsONNPenny DaughertyChandrese FluellenJulie SchreiberMichael ThompsonCherokee , ONNDemetrice JonesForsyth, CCLBarbara ThomasDekalb / Stemmer, CCLRudy Del ValleCherokee CCL Natalie FellersFayetteville, CCLJenise Lewis
18. Case Study60 year old male diagnosed with sarcoma in legMedical insurance but no other benefitsUnable to work due to treatment (recent surgery, planned chemotherapy and radiation therapy)Referred to the Northside Hospital oncology business office for financial assistance for medical bills not covered by insuranceReferred by the medical oncologist office to the nurse navigator (ONN) for support and assistance with barriers to care18
19. Nurse Navigator Assessment and InterventionsNurse Navigator Assessment → Identified barriers to careFinances/bills while on medical leaveHeightened emotional distress; fear of diagnosis and impactNavigation InterventionsConnected the patient and spouse to the Cancer Support Community in addition to connections with oncology social workers for supportConsulted with the CCL for research and identification of resources for mortgage and other financial assistanceProvided FMLA application to the patient and explained the process for completionHand-delivered FMLA paperwork to the medical oncologist office for completion and submittal19
20. Navigator Interventions cont’dContacted financial assistance resources to obtain information and processes to expedite applications Met with the patient and spouse at appointments to provide paperwork, application processes and ongoing emotional supportWorked with the medical oncologist office to obtain medical records needed for applicationsFaxed applications and supporting documentation to financial assistance resourcesServed as a communication liaison between resources and the patient to coordinate additional information and paperwork needed for final application submissionProvided her direct phone number; encouraged patient and spouse to call with questions/concerns20
21. NHCI Oncology Clinical and Support Services Behavioral Health – Counseling and emotional supportGenetic Counseling – Hereditary risk and testingNutritionRehabilitation – P.T., lymphedema therapy, speech/swallowingWound/Ostomy NurseNavigation – Education, support, link to a wide variety of national, regional and local resources Smoking Cessation ClassesSurvivorship – Network of Hope, classes, eventsA Wellness Place – Wigs, head coverings, post-surgical breast garments, compression hoseCancer Support Community – Classes, support groups21
22. Contacting Oncology Patient Navigation Team Phone Call Navigation Main Line: 404-300-2800Email navigator@northside.comMy Contact Information Debbie.Bickes@northside.com
23. Questions?