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Multisite Tumor Navigators

Multisite Tumor Navigators



Jay Swanson, RN, BSN, OCN

Jay Swanson, RN, BSN, OCN
Shanna Gillming, RN, BSN



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    Multisite Tumor Navigators Multisite Tumor Navigators Presentation Transcript

    • Multisite Tumor Navigators
      Jay Swanson, RN, BSN, OCN
      Saint Elizabeth Cancer Institute
      Shanna Gillming, RN, BSN
      Good Samaritan Hospital Cancer Center
    • Objectives
      Discuss concerns with navigation
      Identify potential best practices
      Review case study highlighting the strengths and difficulties of multisite navigation
    • Why Navigate Multiple Sites?
      Small amount of cancer for service area
      Program can only support 1 navigator
      Referral systems not in place
      “Don’t want to leave anyone out”
    • Brainstorming Time
      Take 5 minutes to think about…
      Why are you/do you have a multisite navigator?
      What are the benefits?
      What are the concerns?
      Would you want to be or wish you were specialized?
      Do you have a preferred disease site to navigate?
    • J.M.
      75-year-old woman with stage IV lung cancer
      Navigated at time of diagnosis through treatment
      Including 2 different cycles of chemotherapy
      WB XRT
      Cyberknife to left rib cage
      Now on PO TKI for therapy
    • Thoughts
      What are some thoughts about…
      How often to follow up with this patient?
      What are the main areas of focus for her care?
    • Next Patient
      E.L., 28-year-old woman with gastric cancer
      Navigated for financial assistance through treatment and beyond
      Patient had minimal side effects to chemotherapy
      Always acted like it was not a big deal to be on treatment
      Always had 12-year-old daughter in room
      Admitted over weekend for anxiety and nausea
    • Thoughts
      What are your thoughts about…
      Her care, and what concerns should be addressed with her?
      How does she differ from the patient you saw before her?
      How often should we follow up with her?
    • Then…
      J.C., plasmacytoma - spine
      44-year-old man, lives with significant other
      Uninsured, has worked as a truck driver
      Unable to work as a result of tumor
      Undergoing radiation
      Tolerated radiation treatment fairly well
      Has applied for public assistance
    • Thoughts
      What are your thoughts…
      Regarding his care?
      How does he differ from everyone else today?
    • GYN Patient
      J.N., 56-year-old patient with advanced cervical cancer
      Waitress, uninsured
      Was symptomatic for 2 years with spotting, pain, and weight loss. Waited to see an MD
      Has a sister from California here to care for her
      Borrowing a car from patient’s ex-husband to get back and forth to treatment
      Hospitalized for several weeks with side effects from concurrent chemo/XRT
    • Thoughts
      What are your thoughts…
      What are the barriers here?
      How can a navigator assist this patient?
    • H&N Patient
      S.S., 56-year-old life-long smoker/drinker
      Receiving radiation for 6 weeks
      Using American Cancer Society for rides
      Wife calls daily about concerns
      Pain meds
      Patient never has any concerns; rates distress level 0 on numerous occasions
    • Thoughts on This Case…
      What can we do for this gentleman?
      Is his score concerning?
      What can we do for his wife?
      How is this different from other cancer navigation?
    • Final Thoughts on Case Study
      The purpose of specialization is to be able to provide a more focused knowledge base for care
      How to specialize the following morning?
      Stage IV lung
    • Resources Utilized by Navigators
      American Cancer Society
      Med companies
      Local resources (food, lodging)
      National resources – Healthwell, Chronic Disease Fund, Cancer Care, Patient Advocate Foundation, LLS
      Cleaning for a Reason
      Centers for Medicare & Medicaid Services
    • Next Steps
      Within AONN we have a network
      We have an ability to provide a safe place for multisite navigators
      Certification for Navigation is happening on some level and will only become more prevalent in the coming year
    • Next Steps
      What are your thoughts about…
      Building a place on the AONN site for multisite navigation
      What would we include on the site?
      Any tools that we use that would be helpful?
      Contact information?
      Networking throughout the year to help address concerns, maybe as a teleconference or webinar?