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

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