Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy

Enomoto, Laura M.; Fenstermaker, Joyce; Desnoyers, Rodwige J.; Pasche, Boris; Blackstock, A. William; Howerton, Russell; Clark, Clancy J.; Levine, Edward A.; Shen, Perry

doi:10.1245/s10434-019-07157-6

Cited by 20 publications

(19 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Findings from this study provide evidence to monitor and further explore the impact of increasing integration of primary care and oncology practices with hospital settings and whether these trends improve communication strategies via more organized infrastructure over time. Furthermore, as the implementation of patient navigators continues to grow in diverse ways, including use of nurses, medical assistants, and community health workers [45–48], it is not yet clear whether any one of these strategies improve primary care and oncology relationships for the care of cancer survivors. As more practices are consolidated into health systems or bound to contractual relationships with specific oncology groups, fostering rapport and team-building among clinicians in these settings may be crucial for optimizing the potential of system-based supports [49, 50].…”

Section: Discussionmentioning

confidence: 99%

Understanding primary care-oncology relationships within a changing healthcare environment

et al. 2019

View full text Add to dashboard Cite

BackgroundManagement of care transitions from primary care into and out of oncology is critical for optimal care of cancer patients and cancer survivors. There is limited understanding of existing primary care-oncology relationships within the context of the changing health care environment.MethodsThrough a comparative case study of 14 innovative primary care practices throughout the United States (U.S.), we examined relationships between primary care and oncology settings to identify attributes contributing to strengthened relationships in diverse settings. Field researchers observed practices for 10–12 days, recording fieldnotes and conducting interviews. We created a reduced dataset of all text related to primary care-oncology relationships, and collaboratively identified patterns to characterize these relationships through an inductive “immersion/crystallization” analysis process.ResultsNine of the 14 practices discussed having either formal or informal primary care-oncology relationships. Nearly all formal primary care-oncology relationships were embedded within healthcare systems. The majority of private, independent practices had more informal relationships between individual primary care physicians and specific oncologists. Practices with formal relationships noted health system infrastructure that facilitates transfer of patient information and timely referrals. Practices with informal relationships described shared commitment, trust, and rapport with specific oncologists. Regardless of relationship type, challenges reported by primary care settings included lack of clarity about roles and responsibilities during cancer treatment and beyond.ConclusionsWith the rapid transformation of U.S. healthcare towards system ownership of primary care practices, efforts are needed to integrate strengths of informal primary care-oncology relationships in addition to formal system driven relationships.

show abstract

Section: Discussionmentioning

confidence: 99%

Understanding primary care-oncology relationships within a changing healthcare environment

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Of those who recounted positive supportive care experiences, most recalled being managed by a multidisciplinary team of health professionals, with GPs, cancer care coordinators and palliative care teams often being cited as important sources of support. The role of cancer care coordinators in improving patient experiences is well documented, with studies showing a decrease in time to treatment [26,27], improved patient satisfaction and more streamlined care [28] when a cancer care coordinator is involved. Similarly, a key message which came across in this study was the desire by both patients and caregivers to have access to a liaison person, who would regularly touch base with them, enquire about their needs and offer ongoing support.…”

Section: Discussionmentioning

confidence: 99%

A qualitative investigation of the supportive care experiences of people living with pancreatic and oesophagogastric cancer

Maharaj

Evans

Pilgrim

et al. 2022

BMC Health Serv Res

View full text Add to dashboard Cite

Background Pancreatic and oesophagogastric (OG) cancers have a dismal prognosis and high symptom burden, with supportive care forming an integral component of the care provided to patients. This study aimed to explore the supportive care experiences of patients and caregivers living with pancreatic and OG cancers in order to identify perceived opportunities for improvement. Methods Semi-structured individual interviews were conducted with people living with pancreatic and OG cancers, and their caregivers, across Victoria, Australia during 2020. Interviews were thematically analysed to identify common themes. Results Forty-one participants were interviewed, including 30 patients and 11 caregivers. Three overarching themes, each with multiple sub-themes, were identified: (i) inadequate support for symptoms and issues across the cancer journey (ii) caregiver’s desire for greater support, and (iii) a multidisciplinary care team is the hallmark of a positive supportive care experience. Generally, those who had access to a cancer care coordinator and/or a palliative care team recounted more positive supportive care experiences. Conclusion Unmet needs are prevalent across the pancreatic and OG cancer journey, with supportive care provided to varying levels of satisfaction. Greater awareness of and access to high-quality multidisciplinary support services is greatly desired by both patients with pancreatic and OG cancer and their caregivers.

show abstract

“…The addition of a qualified professional to the care team, whose job it is to eliminate barriers and aid patients as they navigate the healthcare system, creates a focus on patient-centered care and improves timeliness to care. Past studies have shown that nurse navigation reduced time from first contact to intervention anywhere from 5 to 48 days [11,13,15]. Establishing a personal connection with a navigator has been demonstrated to decrease no-show rates thereby improving adherence to surveillance and therapy [12].…”

Section: Discussionmentioning

confidence: 99%

“…The first nurse navigation programs were created in the 1990s to reduce barriers in the healthcare system and provide timely access to healthcare for cancer patients and their families [8,9]. The benefit of such programs for the treatment of breast, colon, cervical, and pancreatic cancer has been demonstrated in the literature [8,[10][11][12][13]. Multiple studies illustrate that nurse navigation programs reduce time to treatment for cancer patients and increase follow-up rates for patients with non-cancerous breast pathology [5,11].…”

Section: Introductionmentioning

confidence: 99%

“…A cost-benefit analysis of patient navigation compared to no navigation found that $95,625 was saved per life-year when patients received a diagnosis of breast cancer six months earlier [14]. Findings from additional studies show that nurse navigation programs increase surveillance mammography rates, reduce wait times to screening mammograms, and improve adherence to hormone therapy, chemotherapy, and radiation therapy [5,6,11,14,15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Impact of Nurse Navigation on Timeliness to Treatment for Benign High-Risk Breast Pathology

Barker

Chung

Mukherjee

et al. 2022

Preprint

View full text Add to dashboard Cite

Purpose High-risk breast pathology is a breast cancer risk factor for which timely treatment is crucial. Nurse navigation programs have been implemented to minimize delays in patient care. This study evaluated nurse navigation in terms of timeliness to surgery for patients with high-risk breast pathology. Methods This was a single-institution, retrospective review of patients with identified high-risk breast pathology undergoing lumpectomy between January 2017 and June 2019. Patients were stratified into cohorts based on periods with and without nurse navigation. Preoperative and postoperative time to care as well as demographic and tumor characteristics were compared using univariate and multivariate analysis. Results 100 patients had assigned nurse navigators and 29 patients did not. Nurse navigation was associated with reduced time from referral to date of surgery (DOS) by 16.9 days (p=0.003). Patients >75 years had a shorter time to first appointment (p=0.03), and patients with Medicare insurance had a reduced time from referral to DOS (p=0.005). 20% of all patients were upstaged to cancer on final surgical pathology. Conclusion Nurse navigation was significantly associated with decreased time to care for patients with high-risk breast pathology undergoing lumpectomy. We recommend nurse navigation programs as part of a comprehensive approach for patients with high-risk breast pathology.

show abstract

Oncology Navigation Decreases Time to Treatment in Patients with Pancreatic Malignancy

Cited by 20 publications

References 17 publications

Understanding primary care-oncology relationships within a changing healthcare environment

Understanding primary care-oncology relationships within a changing healthcare environment

A qualitative investigation of the supportive care experiences of people living with pancreatic and oesophagogastric cancer

The Impact of Nurse Navigation on Timeliness to Treatment for Benign High-Risk Breast Pathology

Contact Info

Product

Resources

About