Multisite Tumor Navigators
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Multisite Tumor Navigators



Jay Swanson, RN, BSN, OCN

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



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Multisite Tumor Navigators Presentation Transcript

  • 1. Multisite Tumor Navigators
    Jay Swanson, RN, BSN, OCN
    Saint Elizabeth Cancer Institute
    Shanna Gillming, RN, BSN
    Good Samaritan Hospital Cancer Center
  • 2. Objectives
    Discuss concerns with navigation
    Identify potential best practices
    Review case study highlighting the strengths and difficulties of multisite navigation
  • 3. 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”
  • 4. 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?
  • 5. 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
  • 6. Thoughts
    What are some thoughts about…
    How often to follow up with this patient?
    What are the main areas of focus for her care?
  • 7. 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
  • 8. 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?
  • 9. 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
  • 10. Thoughts
    What are your thoughts…
    Regarding his care?
    How does he differ from everyone else today?
  • 11. 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
  • 12. Thoughts
    What are your thoughts…
    What are the barriers here?
    How can a navigator assist this patient?
  • 13. 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
  • 14. 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?
  • 15. 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
  • 16. 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
  • 17. 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
  • 18. 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?