Purpose
The COVID-19 pandemic has exacerbated cancer treatment disparities, including accessibility to resources. We describe the process and outcomes of a new proactive, virtual nurse-led, resource center navigation model enhanced by using volunteer patient navigators. Using known patient risk factors, this model provides interventions to reduce barriers to care, with an emphasis on non-English-speaking populations.
Methods
Patients were included if they (1) were in active cancer treatment and (2) had
one or more known risk factors:
distance from cancer hospital, needing complex care, 65 years or older, malignant hematological diagnosis, new treatment start, lives alone, non-English speaker, or a new hospital discharge
.
Nurse navigators triaged referrals to appropriate team members who identified and addressed barriers to care.
Results
The program engaged with 586 adult cancer patients over 1459 encounters. The most common risk factors included distance (59.7%), complex care (48.8%), and new treatment start (43.5%). The most common interventions were core education (69.4%), emotional support (61.2%), and education (35.7%). Statistical differences were found between Spanish-speaking (
n
= 118) and non-Spanish-speaking patients (
n
= 468). While Spanish-speaking patients had fewer risk factors (1.95 vs. 2.80,
p
†.0001), they had nearly double the number of visits (4.27 vs. 2.04,
p
†.0001) and 69% more interventions (8.26 vs. 4.90,
p
†.0001). Many patients (42.7%) required follow-up visits.
Conclusion
We successfully established a new navigation model for the resource center during the pandemic that identified and reduced barriers to care, particularly in the Spanish-speaking population.
Supplementary Information
The online version contains supplementary material available at 10.1007/s00520-021-06147-3.