Cancer Patient Navigation: A Building Block to Improve The Cancer Patient’s Journey

1. Cancer Patient Navigation: A Building Block to Improve The Cancer Patient’s Journey • Corinne Humby RN CON (C) • Alison Power RN, BN, CON (C)

2. Today’s Discussion • History of Cancer Patient Navigation (CPN) • Explore the role of the CPN in Newfoundland and Labrador • Benefits for those accessing CPN services • Referral Process • Question / Answer period

3. Most Canadians will have an experience with cancer, either personally or through someone they know.

4. Cancer Stats • About 2 in 5 Canadians will develop cancer in their lifetime • About 1 in 4 Canadians will die from cancer • More than half of new cancer cases (52%) will be lung, breast, colorectal and prostate cancer • CCS Statistics, CPAC 2015

5. What We Know? • It is important to remember that cancer occurs in the context of the person and their “family” • A cancer diagnosis is often perceived as a life threatening experience • Individuals frequently require support making decisions and day to day adjustments related to their diagnosis • Cancer realities are similar regardless of the type of cancer an individual has or where they live • Patients and families have many needs through out the cancer journey – their needs will change through out the experience and will vary with the individual • Supportive care is critical for everyone – there are many types of supportive care

6. There is more to a person than their cancer diagnosis care for the whole personremember what lies beneath the surface

8. Navigation encompasses the continuum of cancer care • Suspicion or unwell/screening • Investigations • Diagnosis • Treatment • Research • Supportive care • Follow-up • Survivorship • Palliative care

9. “ No person should have to spend more time fighting their way through the cancer care system than fighting their cancer” Harold Freeman MD Surgeon

10. Navigation • A process of working with patients, families and caregivers to provide guidance and help as they negotiate the maze of treatments, services and potential barriers along the cancer journey. It is proactive, intentional and individualized.

11. Cancer Patient Navigation • Cancer Patient Navigation in Newfoundland (2011) • Known barriers to cancer care include: • Financial resources • Communications • Health Care Systems and accessibility • Fear and Distrust • Cultural beliefs

12. Cancer Patient Navigators • Minimum of 5 years current oncology experience • Oncology Certification with Canadian Nurses Association • Cancer Patient Navigation Course Alberta Health Services • Screening for Distress Canadian Association of Psychosocial Oncology

13. Where are Cancer Patient Navigators Located • 3 Eastern Health 1 Central Health • 2 St. John’s 1 Western Health • 1 Clarenville • Labrador/Grenfell • 1/2 St. Anthony • 1/2 Goose Bay • 1/2 Labrador City

14. HOLISTIC CARE • N • U • R • S • E • N • A • V • I • G • A • T • O • R PHYSICAL • SPIRITUAL • EMOTIONAL • PSYCHOLOGICAL • PATIENT • FAMILY • SOCIAL • FINANCIAL • INTELLECTUAL

15. Program Goals • Improve the patient/family cancer journey by: • Increasing capacity for knowledge and support • Increasing capacity to meet identified needs • Improving coordination among individual services at various points and ensuring continuity across all services • Improving timely access to services • Reducing anxiety • Overcome barriers and increase the capacity to access clinical and psychosocial services

16. Cancer Patient Navigators will: • Systematically screen and assess patients/families to identify needs • Link individuals to other members of the health care team and/or community resources to avail of services and programs • Improve continuity and coordination of services throughout the cancer journey • Provide an umbrella of holistic, supportive care • Provide communication between HCP. • Participate on committees geared to help improve the patient cancer journey • Our intention is not to duplicate • but to enhance, augment and streamline care

17. Benefits • Reduce: • wait times • complications of treatment • emergency rooms visits • hospital admissions and length of hospital stay • Duplication of services • Improve: • access to care • Supportive care from the time a cancer is suspected through to diagnosis, treatment and beyond • informational and emotional preparedness for diagnosis and treatment. • patient satisfaction-connected, proactive, empowered • communication among HCP • coordination of care

18. Referral Process • Who can refer: • Any one can refer an individual to the cancer patient navigator as long as the patient is agreeable. Self referrals are accepted. • Who do we see / assist: • Patient / family member / other support persons anywhere along the continuum of care • Health Care Provider seeking services for patients • How do you contact us: • Across the island: Toll free number @ 1-855-848-3888- from land line

19. Navigation Process • Referral received • Individual must agree for CPN to contact them • Individual contacted and an assessment completed • In person or by phone • Based on individual need strategies are identified and plan of care implemented • Number of contacts with the cancer patient navigator varies (single contact / multiple interactions) • Navigator may move in and out of the care circle depending on individual circumstances

20. What needs have been identified ? What kinds of issues have we faced? -Out of province referrals. -Diagnostic testing -Emotional, informational and physical needs -Practical needs-travel places to stay, etc. -Access to programs and services

21. Program Promotion • Pamphlets • Posters • NLMA website • Eastern Health web site • Office Visits • Community liaison-health fairs, public service group meetings • Word of mouth

22. Many contribute to the navigation of individuals touched by cancer – families, friends, co-workers, health care providers, support groups … “A Successful Team Beats With One Heart”

23. Alone we can do so little; together we can do so much. Helen Keller