The MCI acuity tool can be used to validate the need for navigation services and optimize resource utilization. The combination of the MCI acuity measures and standardized metrics, such as the 35 evidence-based metrics developed by AONN+, can be used to support the impact of navigation on ROI and patient outcomes.
Navigation at the Levine Cancer Institute, a community-based cancer center in Charlotte, North Carolina, comprised of 7 facilities, was facing several challenges, Kris Blackley, Rn, MSN, BBA, OCN®, explained. The team of 30 navigators did not have standardized processes; roles and tasks were different in every clinic and at every facility. Their documentation was not standardized so some excel spreadsheets used different fields, and in some cases, there was no documentation. This meant navigators had no way to track their patients or collect information.
The average caseload was approximately 200 to 250 patients per month. Patients moved between several facilities in the course of their care, and navigators experienced difficulty keeping track of patients and their treatments, especially when navigators were not told of changes. In addition, they found that their hospitalist system is not always the most efficient way to handle patient navigation.
Therefore, the goals for the navigation team were to provide consistent quality navigation services at all facilities, facilitate communication across the multiple facilities, and assess the quality and effectiveness of navigation. That is, they wanted to be able to show the value of what their navigators do. The team also wanted to be able to assess the program from a management perspective and conduct original research on navigation.
Ms Blackley and her team developed an Information Systems (IS) tool that supports standardized navigation practice and data collection, helps to manage large patient cohorts more effectively, captures metrics of a rapidly growing multicenter navigation program, and facilitates communication across all facilities. “We wanted to keep people from working in silos,” she said.
Within the electronic medical record (EMR), the tool allowed the navigators to standardize resources and practices. Navigators could manage patients consistently across all the facilities, view patients’ appointments, and receive alerts regarding patient visits to the ED or hospital admissions, all within the 1 system.
The results of this effort were overall better patient service. Navigators were able to be proactive with hospital admissions. Merging multiple systems allowed for more accurate information and better time management.
Research outcomes presented at ASCO and ASPO demonstrated that overall survival was improved at 12 months among navigated vs non-navigated patients across all subgroups measured. The strongest benefits were seen among blacks, Medicaid patients, and patients with pancreatic or lung cancer. In addition, 30-day readmissions were reduced in navigated patients vs non-navigated patients.
Baldwin DL, Blackley K. Using metrics and data to enhance the navigation workflow. Oral presentation at: 2018 ONA Navigation Summit; June 14-16, 2018; Chicago, IL.