Nurse Navigators Improve Physician Engagement in Pretreatment Discussions

After involving nurse navigators in the conference process for patients with head and neck cancer, clinician engagement increased.
After involving nurse navigators in the conference process for patients with head and neck cancer, clinician engagement increased.

Oncology nurse navigators improved physician engagement in multidisciplinary discussions prior to the initiation of treatment for patients with head and neck cancer, according to a study that will be presented at the 2017 American Society of Clinical Oncology (ASCO) Quality Care Symposium.1

After recognizing that a multidisciplinary approach is the best practice for the treatment of patients with head and neck cancer, researchers at Aurora Health Care in Milwaukee, WI, sought to evaluate whether cancer nurse navigators and system-wide high definition video conferencing facilitates multidisciplinary discussions in the treatment of these tumors.

Prior to the involvement of oncology nurse navigators, providers discussed 77% of 75 newly diagnosed head and neck cancer cases with prospective multidisciplinary discussion prior to therapy initiation. Investigators designed performance improvement initiatives to increase the proportion of patients discussed during a multidisciplinary conference.

These initiatives included: weekly review of all head and neck cancer cases by a lead nurse navigator identified through EPATH; electronic communication from the navigator requesting physician presentation of their patients at the multidisciplinary conference; engagement of site-specific nurse navigators to schedule their provider's patients for the conference; and collaboration with cancer registrars to place their site-specific patients on their local or system conference case list.

In addition, nurse navigators followed up with providers on patients not presented at the conference and offered timely feedback to referring providers on recommendations for presented patients.

Following implementation of these initiatives, investigators observed a significant increase in the percentage of patients being presented (P = .005). Compared with before implementation, providers presented 93% of 102 head and neck cancer cases following the introduction of cancer nurse navigators.

The authors concluded that by involving oncology nurse navigators in the multidisciplinary conference process for patients with head and neck cancer, physician engagement increased and practice patterns with respect to patient assessment changed.

Reference

1. Werner V, Barry-Weers A, Weese JL, Corsten M. Effect of cancer nurse navigators (CNN) on physician engagement in multidisciplinary discussions prior to head and neck cancer treatment. J Clin Oncol. 2017; 35 (suppl 8S; abstract 98).

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