Hanna Kemeny, Oncology Roundtable
Following a cancer diagnosis, patients need assistance navigating a new and unfamiliar medical world. Providing individualized help with coordinating appointments, finding support groups, and understanding medical jargon can benefit both patients and their families.
A pilot program at Group Health has addressed these needs by pairing oncology nurse navigators with newly diagnosed breast, colorectal, and lung cancer patients for four months. These navigation services, which increase one-on-one contact and conversations between nurses and patients, have been effective in improving the patient experience.
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As part of our 2010 research on patient navigation, our research team assembled a list of certification and training programs for navigators. We've included the prerequisites for participation, a summary of the curriculum and certification process, credentials earned, and cost.
Due to page restrictions, we weren't able to fit it into our latest publication on navigation, but you can view this information in the below PDF.
Earlier this week, I had the opportunity to attend a presentation by Dr. Tom Smith from VCU Massey Cancer Center. He talked about the many challenges that oncologists face when trying to communicate with patients about their diagnoses, treatment options, and end-of-life care. One of the tools that he has been using to facilitate communication with patients at his own practice is a written plan of care. In his experience, a written plan of care not only improves communication but also can save time.
When patients come in for a consult, Dr. Smith sits down next to them and writes down all of the critical information that he wants them to take away. He tells the patient that they will get a copy of the document, and he makes notes as the conversation progresses. The end result is a written plan of care which the patient can take with them for future reference and share with family. The physician similarly can add the document to the patient's medical record and fax it to the patient's PCP and radiation oncologist.
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All of you are familiar with the work that Lance Armstrong's Foundation LiveStrong has been doing to promote survivorship care. Recently, the foundation has turned its attention to patient navigation and providing support services to patients and families. While the program is still in development, the goal is to roll out a nation-wide service that helps patients to find "the right resources at the right time."
According to our contact at LiveStrong, the initiative came about organically. People who were familiar with LiveStrong would call the foundation looking for advice and support, and the Foundation staff would try to respond as best they could. Given the demand, the foundation has been working across the past year to develop more formalized resources and services.
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The Daily Briefing ran this report today, which I thought might be of interest. It speaks to the classic problem of poor communication between patients and physicians, and misperceptions on both sides. I know that many Roundtable members are seeking to address this issue by deploying patient navigators, a subject that we will be exploring further in our National Meeting series this year.
"Communication lapses between providers and patients may explain why blacks with lung cancer are less likely to undergo potentially lifesaving resection surgery compared with white patients, according to a study in JAMA.
Although surgical resection is the "only reliable treatment" for patients with stage I or II non-small cell lung cancer and has been shown to significantly improve mortality rates, not all patients undergo the procedure. To understand why resection surgery rates are not more prevalent, researchers from the University of North Carolina (UNC)-Chapel Hill surveyed 437 patients with early-stage non-small cell lung cancer undergoing treatment at five health systems in North and South Carolina about physician-patient communication, trust, attitudes toward cancer, health history, and functional status between December 2005 and December 2008.
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