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Affiliations

Levine Cancer and Wake Forest Baptist

Presentation Notes

Nurse-driven Innovations in Care Redesign and Delivery poster presentation at Elevating Nursing Excellence: Purpose, Profession, Passion; Advocate Health Midwest Region Nursing Research & Professional Development Conference 2024; November 13, 2024; virtual.

Abstract

Introduction and Context: Inconsistent data collection and reporting is one of the biggest threats to supporting a navigation program 1. Quality data is used to capture navigation outcomes that emphasize the importance and support expansion of navigation programs. Previous documentation at Levine Cancer (LC) and Wake Forest Baptist (WFB) was limited and most of the information was documented in narrative form. Oncology programs at LC and WFB integrated, requiring navigation teams to create a new shared documentation tool that would capture detailed and measurable data to enhance outcome reporting.

Implementation Strategy: Representatives from LC and WFB met routinely to merge documentation tools. Comprehensive flowsheets with discrete data fields were adapted to capture a barrier and needs assessment, acuity level, referrals made, education performed, type of contact, and the time spent with each patient. Once the tools were merged, LC and WFB met with the Information Systems team to build the documentation flowsheet and provide a data reporting framework.

Outcomes and Impact: Previous reports for documentation across sites had limitations and varied in the number of data elements. The new documentation tool provides multiple flowsheets that allow collection of extensive information about patient's barriers and needs and interventions performed by the navigator, which is now utilized by over 50 nurse and patient navigators. Development of flowsheets with discrete fields makes data collection and reporting more reliable and accurate. These discrete fields also maximize data completeness and standardized structure2.

Insights: By creating a concise and thorough way to collect information in the EMR, it is readily available, accessible, consistent, and allows for better workflow. Streamlining this information provides site-specific trends and allows for larger evaluation, research, and outcome reporting.

Implications: Future plans include further adaptation to additional forms of navigation, such as screening navigation. Flowsheet data will also support establishing navigation as a reimbursable service in the future3.

References

  1. Battaglia, T., Fleisher, L., Dwyer, A., Wiatrek, D., Well, K., Wightman, P., Strusowski, T., & Calhoun, E. (2022). Barriers and opportunities to measuring oncology patient navigation impact: Results from the National Navigation Roundtable survey. Cancer, 128, 2568-2577. https://doi.org/10.1002/cncr.33805

  1. Bush, R., Kuelbs, C., Ryu, J., Jian., W., & Chiang, G. (2017). Structured data entry in the electronic medical record: Perspectives of pediatric specialty physicians and surgeons. Journal of Medical Systems, 41(5), 75. https://doi.org/10.1007%2Fs10916-017-0716-5

  1. Garfield, K., Franklin, E., Battaglia, T., Dwyer, A., Freund, K., Wightman, P., & Rohan, E. (2022). Evaluating the sustainability of patient navigation programs in oncology by length of existence, funding, and payment model participation. Cancer, 128(513), 2758-2589. https://doi.org/10.1002/cncr.33932

Document Type

Poster

Publication Date

11-13-2024

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Nov 13th, 12:00 AM

Creating a Comprehensive Navigation Documentation Tool to Improve Reporting

Introduction and Context: Inconsistent data collection and reporting is one of the biggest threats to supporting a navigation program 1. Quality data is used to capture navigation outcomes that emphasize the importance and support expansion of navigation programs. Previous documentation at Levine Cancer (LC) and Wake Forest Baptist (WFB) was limited and most of the information was documented in narrative form. Oncology programs at LC and WFB integrated, requiring navigation teams to create a new shared documentation tool that would capture detailed and measurable data to enhance outcome reporting.

Implementation Strategy: Representatives from LC and WFB met routinely to merge documentation tools. Comprehensive flowsheets with discrete data fields were adapted to capture a barrier and needs assessment, acuity level, referrals made, education performed, type of contact, and the time spent with each patient. Once the tools were merged, LC and WFB met with the Information Systems team to build the documentation flowsheet and provide a data reporting framework.

Outcomes and Impact: Previous reports for documentation across sites had limitations and varied in the number of data elements. The new documentation tool provides multiple flowsheets that allow collection of extensive information about patient's barriers and needs and interventions performed by the navigator, which is now utilized by over 50 nurse and patient navigators. Development of flowsheets with discrete fields makes data collection and reporting more reliable and accurate. These discrete fields also maximize data completeness and standardized structure2.

Insights: By creating a concise and thorough way to collect information in the EMR, it is readily available, accessible, consistent, and allows for better workflow. Streamlining this information provides site-specific trends and allows for larger evaluation, research, and outcome reporting.

Implications: Future plans include further adaptation to additional forms of navigation, such as screening navigation. Flowsheet data will also support establishing navigation as a reimbursable service in the future3.

References

  1. Battaglia, T., Fleisher, L., Dwyer, A., Wiatrek, D., Well, K., Wightman, P., Strusowski, T., & Calhoun, E. (2022). Barriers and opportunities to measuring oncology patient navigation impact: Results from the National Navigation Roundtable survey. Cancer, 128, 2568-2577. https://doi.org/10.1002/cncr.33805

  1. Bush, R., Kuelbs, C., Ryu, J., Jian., W., & Chiang, G. (2017). Structured data entry in the electronic medical record: Perspectives of pediatric specialty physicians and surgeons. Journal of Medical Systems, 41(5), 75. https://doi.org/10.1007%2Fs10916-017-0716-5

  1. Garfield, K., Franklin, E., Battaglia, T., Dwyer, A., Freund, K., Wightman, P., & Rohan, E. (2022). Evaluating the sustainability of patient navigation programs in oncology by length of existence, funding, and payment model participation. Cancer, 128(513), 2758-2589. https://doi.org/10.1002/cncr.33932

 

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