Quantifying the Impact and Value of Oncology Navigation on Patient Outcomes
Tricia Strusowski, MS, RN, Manager at Oncology Solutions and Chair of the Academy of Oncology Nurse & Patient Navigators (AONN+) Evidence into Practice Metrics Subcommittee, and Danelle Johnston, MSN, RN, ONN-CG, OCN, Chief Nursing Officer and Senior Director of Strategic Planning & Initiatives of The Lynx Group, led an informative breakout session discussing the development and implementation of oncology nurse navigation metrics.
These efforts began in 2005 when the Patient Navigation Research Program undertook an initiative to define common metrics, processes, and outcomes for patient navigation. The advent of value-based cancer initiatives such as the Oncology Patient Centered Medical Home, the COME HOME pilot, and the OCM elevated the importance of oncology navigation and provided the impetus for the development of metrics specific to nurse navigation. Initial efforts were guided in part by the Quality Oncology Practice Initiative, which developed more than 100 different measures in an effort to standardize best practices in clinical outcomes and patient experience. Drawing on these previous initiatives, an AONN+ task force was convened. This task force developed 35 standardized measures in 8 different knowledge domains that all institutions can use, regardless of their specific model of navigation.
In a continuation of these efforts, in March 2018 a partnership of the American Cancer Society, Chartis Oncology Solutions, and AONN+ launched a study to assess the reliability and validity of 10 key metrics selected from the list of 35 developed by AONN+, by implementing a study at 8 different community and academic cancer centers across the United States. The study seeks to evaluate evidence-based standardized navigation metrics and identify navigation outcome measurement best practices.
The faculty agreed that the ongoing initiative is vital, as the cancer navigation role is more important than ever because of the complexity of the healthcare system, as well as the rising cost of care for patients. In particular, Ms Strusowski noted that transitions of care are a particularly critical time for patients. As cancer delivery systems build infrastructure to support patients, a number of challenges must be addressed—training nurses to be oncology nurse navigators, understanding community barriers, and teaching about collaborative practice. In addition, the faculty maintained that the development of validated measures to demonstrate the impact of oncology navigation on quality cancer care delivery, return on investment, patient experience, and program sustainability are important in determining the value of navigation programs to cancer care. The use of standardized metrics, focusing on evidence-based practice, can therefore serve as a key contributor to broader efforts to promote patient-centric, value-based cancer care.