Menu

Optimizing Nurse Navigator Caseloads in a Pediatric Multidisciplinary Clinic Using a Novel Pediatric Patient Acuity Tool!

December 17, 2021 | November 2021 Vol 12, No 11 | Operations Management, Health Economics
Featuring:
Bryce Marshall
University of Cincinnati
College of Medicine
Cincinnati, OH
Austin VonAxelson, MD
University of Cincinnati
College of Medicine
Cincinnati, OH
Jennifer Thomas, DNP, RN
University of Cincinnati
College of Medicine
Cincinnati, OH
Brienne Merten, BSN
University of Cincinnati
College of Medicine
Cincinnati, OH
Luke Byerly
University of Cincinnati
College of Medicine
Cincinnati, OH
James Young
University of Cincinnati
College of Medicine
Cincinnati, OH
Cynthia Downard, MD
University of Cincinnati
College of Medicine
Cincinnati, OH
In Kim, MD, MBA
University of Cincinnati
College of Medicine
Cincinnati, OH
Beth Spurlin, MD
University of Cincinnati
College of Medicine
Cincinnati, OH

Introduction: Patient navigation programs assist in the management of patients with complex medical problems. Whereas ample literature exists about the implementation of nurse navigators in adult oncology clinics, there is sparse information relating to the outpatient pediatric subspecialty setting.

Objective: To create a model for outpatient pediatric subspecialty nurse navigators using a pediatric patient acuity assessment tool.

Methods: A retrospective review of literature was used to determine current practices in navigator caseload management. Meta-analysis, primary studies, and institutional personnel guides were compared, mostly in the adult oncology literature. We explored multiple factors by which caseload can be defined, including total patients per navigator, average time per patient, duration of navigation, number of calls per patient, and acuity tool models.

Results: Patient acuity stood out as the primary method for determining nurse navigator caseloads. Using existing adult acuity tools, we developed a novel pediatric patient acuity tool (PAT) by modifying a preexisting adult PAT to model caseloads for each pediatric nurse navigator. Our acuity tool considered multiple factors: patient status, complex care needs (feeding tube, physical therapy, tracheostomy management), frequency of contact or poor psychosocial support to generate the PAT score. Patients were then stratified into low, moderate, high, or very high acuity based on this scoring system. The PAT score had the advantage of correlating to the time commitment per patient visit, which can be used to determine the length of patient time slot scheduling and thus be used to generate caseloads. Baseline models indicated that caseloads started with 100 low acuity patients and then adjusted to fit the needs of the subspecialty clinic.

Conclusions: Patient acuity is an excellent metric for patient navigation caseload management. Using the PAT score, pediatric nurse navigators can manage a caseload of pediatric patients of varying acuity and complexity. In addition, this score allows for an objective dynamic caseload management system that can be customized to the unique needs of each pediatric multidisciplinary clinic and nurse navigator.

Sources

Baldwin D, Jones M. Developing an acuity tool to optimize nurse navigation caseloads. Oncology Issues. 2018;33(2):17-25.

Cantril C, Haylock PJ. Patient navigation in the oncology care setting. Semin Oncol Nurs. 2013;29:76-90.

Related Articles
Information and Support Needs of People with Newly Diagnosed Metastatic Breast Cancer
Stefanie Washburn, MSW, LSW, Catherine L. Ormerod, MSS, MLSP, Kathleen D. Swiger, MPH
December 17, 2021 | November 2021 Vol 12, No 11 | Operations Management, Health Economics
Metastatic breast cancer patients report a lack of information tailored to their diagnosis.
Providing Accommodations to Ease Financial Toxicity for Radiation Patients
Shelita Anderson, MBA, BSN, RN, OCN, Phoebe Dawn Spencer, RN, BSN, OCN, Janetta Thomas, MSN, RN, OCN
December 17, 2021 | November 2021 Vol 12, No 11 | Operations Management, Health Economics
According to a 2013 Institute of Medicine report, cancer treatment costs are escalating rapidly and resulting in less affordable care options for patients.
The Impact of an Electronic Health Record to Advancing Nurse Navigation Using Standardized Metrics in a Healthcare System
Jeanne Silva, MSN, RN-BC, CMSRN, CN-BN, Avni Patel, BSN, RN
December 17, 2021 | November 2021 Vol 12, No 11 | Operations Management, Health Economics
As the healthcare landscape is evolving from independent hospitals to large healthcare systems, the challenge of standardizing programs such as navigation becomes paramount to ensuring best practices and service consistency.

Thank You to Our Corporate Sponsors and Alliance Partners!

  • Patron Corporate Sponsor

    Patron Corporate Sponsor

  • Patron Corporate Sponsor

    Patron Corporate Sponsor

  • Patron Corporate Sponsor

    Patron Corporate Sponsor

  • National Alliance Partner

    National Alliance Partner

  • Patron Corporate Sponsor

    Patron Corporate Sponsor

  • Patron Corporate Sponsor

    Patron Corporate Sponsor

  • Patron Corporate Sponsor

    Patron Corporate Sponsor

  • Industry Relations Council Member

    Industry Relations
    Council Member

  • Industry Relations Council Member

    Industry Relations
    Council Member

  • National Alliance Partner

    National Alliance Partner

  • National Alliance Partner

    National Alliance Partner