Breaking News: The Results of the National Navigation Metrics Outcomes Study Are In!
Attendees were fully engaged as the results of this landmark exploratory study were reviewed in-depth by metrics study team members Danelle Johnston, MSN, RN, HON-ONN-CG, OCN, Senior Director, Strategic Planning & Initiatives, The Lynx Group/AONN+, Co-Principal Study Investigator; Lesley Watson, PhD, Principal Scientist, Statistics & Evaluation, American Cancer Society, Co-Principal Study Investigator; Tricia Strusowski, MS, RN, Manager, The Chartis Group, Chartis Oncology Solutions Practice, Chair, AONN+ National Metrics Committee, Study Investigator; Elaine Sein, BSN, RN, Consultant, Study Investigator; Kelley D. Simpson, MBA, Director and Partner, The Chartis Group, Chartis Oncology Solutions Practice, Study Investigator; and Alex Glonek, ONC iQ Developer and Lead Consultant, The Chartis Group, Chartis Oncology Solutions Practice, Study Investigator. As these findings will translate to navigation practice in the future, oncology navigators were eager to learn more about the methods of the study and the parameters of the outcomes and the selected benchmarks.
The multidisciplinary metrics study team was a collaborative effort between AONN+, Chartis Oncology Solutions, and the American Cancer Society. They launched the study in June 2018 and closed the data collection on April 30, 2019. Eight sites were selected from which to collect the metrics over a 6-month period. Prior to study launch, available historical data from the previous 3 years were provided by the study sites. Metrics data were uploaded into the ONC iQ® NAVmetrics™ cloud-based business intelligence platform to create participant-specific dashboards.
The team also collected qualitative data on facilitators—and the barriers to metrics tracking—by observing monthly calls between each site and the study team, through pre/post key informant interviews, and the documentation of quality improvement (QI) activities.
When all the data had been collected, 10 navigation metrics from a list of 35 evidence-based metrics developed by AONN+ were evaluated for reliability and availability. The selected metrics include barriers to care; time from diagnosis to initial treatment; navigation caseload; number of navigated patients readmitted to the hospital at 30, 60, and 90 days; psychosocial distress screening; social support referrals; palliative care referrals; identifying patient learning-style preference; navigation knowledge at time of orientation; and patient experience/satisfaction with care. The study also yielded insight into the barriers and challenges that are encountered by navigation programs when they implement navigation metrics.
The team also discussed the next steps they plan to take in this ongoing project, which include publication of the results, an implementation tool kit, and an AONN+ Acuity tool to further refine the caseload metric.
Hot Topics in Oncology Care: Cannabis and the Opioid Crisis
Carey S. Clark, PhD, RN, AHN-BC, FAAN, Associate Professor of Nursing, University of Maine at Augusta Chair, Cannabis Certificate Program at Pacific College President, American Cannabis Nurses Association; and Eileen Konieczny, RN, BCPA, CPEOLD, Past President, American Cannabis Nurses Association presented a powerful session on the use of medicinal cannabis. The comprehensive discussion looked at the potentially controversial topic from a variety of angles—ethical, legal, and medical. It explored issues of social justice, the role of the nurse, the effect of cannabis on the body, and the relative addictive properties of cannabis compared to other popular drugs including caffeine and nicotine. It also grappled with the way in which navigators’ beliefs about using medicinal cannabis in practice can be conflicting and complex. Considerable time was spent, both in the prepared discussion and in the Q&A, on many legal dimensions, as the acceptance and use of medicinal marijuana varies greatly by state, with possibly serious consequences for breaking the law either as a provider or patient. Dr Clark and Ms Konieczny also provided sources for more information especially about legislation and convincingly advocated for equality in access at the federal level.
The presentation A Societal Challenge: Executing Opioid Safe Practices for Cancer Patients by Tonya Edwards, MS, MSN, FNP-C, Palliative Care & Rehabilitation Medicine, UT MD Anderson Cancer Center, on the problem of opioid overuse was very different in tone. Whereas Dr Clark and Ms Konieczny were advocates for an expansion in use of a pain easing drug considered by many to be safe and effective with a low possibility of addiction, Ms Edwards’s challenge is reining in the escalating problem that is arising from the abuse of widely prescribed pain relievers—opioids. As she implored many times during her dynamic presentation, it is a problem that calls for “all hands on deck” if it is to be surmounted. She argues that prevention of abuse starts at the time the medication is prescribed, not when it has become a problem. Her presentation was full of readily employable suggestions and methods of best practice when dealing with opioid addiction and how to avoid it in the clinical setting.
Policy Issues Impacting Patients in Need: An Advocacy Primer
Elizabeth Franklin, MSW, Debra Kelly, RN, BSN, OCN, ONN-CG, Jamie Callahan, BSN-RN, OCN, CBCN, Brenda Farmer, RN, CN-BN, ONN-CG, and Kerri Medeiros, RN, BSN, OCN, ONN-CG(T) presented a nuts-and-bolts session on becoming an advocate for patients in need. In their role meeting patients’ needs, navigators should be aware of, and be able to provide information and feedback on, current laws as well as pending legislation and policies. AONN+ is active in the policy and advocacy space and encourages members to join in furthering the organization’s aims through committee work, or to take up advocacy issues related to patient needs on their own.
As Ms Franklin stressed, and other panelists agreed, navigators are experts in oncology patient care and have much to offer.
Although taking steps towards becoming an active grass-roots advocate may seem intimidating at first, this session laid out the process in an entirely accessible way. “Advocacy 101” offered practical steps and an introduction on how to get involved in both big and small ways and at any level of government.
The AONN+ Policy and Advocacy Committee discussed its mission to “Utilize legislative, regulatory, and policy advocacy to protect and promote the practice of oncology patient navigation in order to best serve individuals and families impacted by cancer,” and reached out to members to join this committee to help further its goals of promoting access to comprehensive, timely, affordable, and high-quality cancer care for all patients through public policy and grassroots advocacy; identifying policy opportunities to advance the patient navigation profession; developing grassroots tools; encouraging AONN+ members to engage in policy advocacy; and working with allied organizations on policy issues of common interest.
Some “hot topic” issues with which oncology navigators have advocated for change include death with dignity policies and the expansion of Medicaid, and case studies on both of these topics were featured. In addition to outlining the advocacy steps taken, they also provided excellent background to these issues, detailing the existing legislation and underscoring the areas in which changes are most needed.
This was an inspiring session that should motivate many more members to join this committee or others or take up advocacy work on their own.
Networking and New Knowledge in Exhibit Hall—And Say Hello to the CONQUER booth!
In addition to showcasing all the latest information about oncology-related products and services, the Exhibit Hall at the Annual Conference was the launch site for our brand new CONQUER: the patient voice booth. We wanted to reach out to ensure that all navigators are able to leverage the content in the magazine and our companion CONQUER website, so we developed this booth just for navigators and just for CONQUER. We created some handy materials for you to use in your practice, produced a video (conveniently uploaded to its own “business card” flash drive) to walk you through our patient-friendly website, and heard your comments and suggestions about CONQUER. We enjoyed talking with everyone who stopped by and we loved hearing how much you and your patients love CONQUER. Look for the CONQUER booth at future conferences and see what’s happening.
Celebrating a Decade of AONN+: The 10-Year Celebration Party Rocked!
Suspense built over the early evening as the main foyer in front of the ballroom was blocked from view by panels of curtains. Brightly colored lighted signs welcomed one and all to the event. At 7:30, attendees were invited in to an entirely transformed space—the previous registration and gathering space had become a festive carnival midway complete with costumed guests, booths offering flip books and caricatures and an array of festive treats—hot pretzels, freshly spun cotton candy, and even funnel cakes! Before long, guests were welcomed into the large ballroom for hours of dancing, cocktails, and more opportunities for souvenir photos of the event. The live band had everyone up and dancing until well into the night. Truly a wonderful night of socializing and fun to cap off several days of intense focus and engagement.