Highlights from Saturday, November 18, 2017

Conference Highlights published on November 18, 2017 in 2017 Annual Conference

Attendees were up early Saturday, and eager for another jam-packed day of learning. In addition to the multitude of insightful sessions ahead of them, many were looking forward to hearing from this year’s keynote speaker and world-class gymnast, Shannon Miller.

Product Theaters Highlight New Treatment Approaches

Sharon S. Gentry, RN, MSN, CBCN, AOCN, ONN-CG, led off the morning’s Product Theaters with a Puma Biotechnology‒sponsored presentation about NERLYNX. This treatment for women with early-stage HER2+ breast cancer gives clinicians an additional tool to help reduce the risk of recurrence. During her presentation, Sharon provided an overview of early-stage HER2+ breast cancer, the role that NERLYNX plays in the treatment of this condition, and associated prescribing, dosing, and safety guidelines.

The Insys-sponsored Product Theater, led by Caroline Elistin, DNP, MSN-Ed, ARNP, FNP-BC, Nurse Practitioner, focused on SYNDROS. This novel treatment is for patients with chemotherapy-related nausea and vomiting. In addition to providing an overview for SYNDROS, Caroline talked about SYNDROS Cares, which provides copay cards and compassionate assistance for qualifying patients, personalized education for providers and patients, and assistance with prior authorizations through specialized pharmacies.

During her lunchtime Product Theater, sponsored by Celgene, Kathleen Colson, RN, BSN, BS, talked about REVLIMID® for multiple myeloma patients. She began her presentation with an overview of multiple myeloma, focusing on treatment response. Kathleen then covered clinical trials data for the treatment as well as dose modifications, safety information, and common causes for dose discontinuation, interruptions, and reductions. She shared that, today, we know more about this disease than in the past and can better manage treatment-related side effects. However, she emphasized that supportive care is key for these patients.

Recognizing resistance to and intolerance of hydroxyurea in polycythemia vera (PV) patients was the subject of a lunchtime Product Theater presented by Maureen Thyne, PA, and sponsored by Incyte. The session focused on the use of Jakafi® for treatment of patients with PV. Jakafi is the only approved drug in this field and was tested through the RESPONSE trial. Through case studies, session attendees also learned about PV, the efficacy and safety data from the RESPONSE trial, and dosing information for Jakafi.

Lynn Stuart Ashby, MD, opened her Arbor Pharmaceuticals‒sponsored Product Theater by sharing how early experiences with glioblastoma patients led her to become a neuro-oncologist. She then talked about the pathology and grading of a glioblastoma. Her talk shifted to survival rates and the evolution of treatment, thereby setting the stage for a discussion about the GLIADEL® wafer. Dr. Ashby discussed clinical trial data for this treatment, its accessibility, and efficacy in extending survival time. She closed her presentation by emphasizing the importance of clinical trials in the pursuit of additional treatments for this condition.

At an afternoon Product Theater, Kristen Miller, MSN, spoke to attendees about the use of ALUNBRIG® for patients with non‒small-cell lung cancer that has a certain type of abnormal anaplastic lymphoma kinase (ALK) gene. She presented a case study of a patient with central nervous system progression on crizotinib, as well as ALUNBRIG guidelines, dosing recommendations, warnings, and precautions.

World Champion, Cancer Survivor Discusses “the Gold Medal Mindset” in Keynote Speech

To the swelling music of the Olympic fanfare and video clips of her gold medal performances in the 1996 Atlanta games, world champion gymnast and cancer survivor Shannon Miller took the stage for her Saturday morning keynote address at AONN+’s Eighth Annual Navigation & Survivorship Conference.

During her presentation, titled “The Gold Medal Mindset: Cancer & Survivorship,” Shannon recounted the thoughts, feelings, struggles, and triumphs that she experienced leading up to these Olympics and other critical competitions throughout her career.

Shannon’s speech took a more serious turn when she shared her own story of being diagnosed with ovarian cancer.

“Never did I imagine that I’d have the title of cancer survivor before the age of 34,” she shared.

To get through her treatment and recovery, Shannon says that she reverted to her competitive mentality, fighting to win against negative thoughts. She shared that this was a struggle every day, particularly as treatment-related side effects, such as hair loss, neuropathy, and nausea, came along.

“I had to look at these as part of the process of me getting healthy,” Shannon said.

Goal setting was important to her recovery, much as it was when she was training for the Olympics. She shared that it was her goals that got her through the monotony of long practices and challenging times. Although they were smaller victories, doing things like taking a walk or getting dressed were just as thrilling during her treatment.

Winning a gold medal takes a team, and so does beating cancer. Shannon talked about her cancer support team—doctors, nurses, family, friends—who helped her throughout the process.

“Let us celebrate you and what you do for your patients and their families,” she said, addressing the audience. “It is amazing and inspiring.”

Shannon closed with a discussion about the insight that she gained through her cancer journey.

“Making our health a priority isn’t a selfish act; it’s critical to those whom we care for,” Shannon said. “In addition to caring for your patients, please remember to take care of yourselves as well.”

Presentation Explores Next Steps for Standardized Evidence-Based Navigation Metrics

Never fear! The Navigator Superheroes are here.

Members of AONN+’s Evidence into Practice (EIP) Committee rolled out their super powers for a highly entertaining and educational skit about the DOMAINS of certification and their superhero alter egos.

This skit was the perfect segue into the EIP’s presentation about Standardized Evidence-Based Navigation Metrics.

During their presentation, Pursuing Superior Quality Standardized Oncology Navigation Metrics: Phase II, EIP Committee members Tricia Strusowski, MS, RN, Manager, Oncology Solutions; Danelle Johnston, RN, MSN, ONN-CG, OCN, CBCN, Chief Nursing Officer, Senior Director of Strategic Planning and Initiatives, The Lynx Group; and Elaine Sein, RN, BSN, CBCN, Consultant, discussed the goals and progress of the AONN+ Standardized Metrics Research Study–Phase II Initiative.

Elaine opened this session with a review of the 35 Standardized Oncology Navigation Metrics and the methodology that the committee used to develop them.

She was followed by Danelle, who introduced the Phase II initiative, which aims to develop a metrics repository for programs to report outcomes, lessons learned, and performance improvement initiatives that have been implemented to enhance and improve navigation processes. This will provide a means through which programs can share data nationally and begin to develop standardized reporting.

Tricia then took the stage to give the big-picture perspective regarding this metrics work.

“Our metrics crosswalk with national standards,” she said. “For this reason, people are paying attention to these metrics and what we’re doing as an organization. That’s powerful stuff.” She also talked about AONN+’s partner in the Phase II study, Oncology Solutions Group. This organization was selected based on its dedication to oncology, understanding for the scope of the project and its complexity, a demonstrated ability to create value, and a collaborative spirit.

Later in the day, Tricia took the stage once again with Cheryl Bellomo, MSN, RN, OCN, ONN-CG, Oncology Nurse Navigator and Oncology Clinical Trials Coordinator, Intermountain Southwest Cancer Center, Cedar City Hospital, Cedar City, Utah, to talk about how navigators can implement the Standardized Oncology Navigation Metrics into their practice.

Cheryl led off with a discussion about how the metrics were developed, highlighting the importance of the 3 categories—patient experience, clinical outcomes, and return on investment—that dominated their literature review of source documents.

Tricia took the microphone next to talk about how the use of these metrics can help navigators provide better patient outcomes, enhance partnership with providers, and create sustainability for their navigation program.

Metrics case scenarios were used to provide real-world applications of the metrics in navigation practice.

Breakout Sessions Place Focus on Specific Navigation-Related Issues

Each year, breakout sessions provide attendees with the opportunity to focus their attention on the issues that affect them directly in their day-to-day activities. The first breakout session of the day focused on tumor-specific navigation and offered discussions related to breast cancer; thoracic cancer; complex gastrointestinal, genitourinary, and head and neck cancers; along with neuro-oncology.

Breast Cancer Breakout Session

This presentation by Carrie Stauder, BA, RT, (R)(M), Patient Navigator for Mary Lou Beshears Breast Care Center, Memorial Hospital, University of Colorado Health, Colorado Springs, and Susann K. Burnett, RN, BS, CN-BN, Breast Nurse Navigator, Women’s Wellness Center, Mission Hospital, Mission Viejo, California, offered ways to develop cross-collaboration between the breast patient navigator and oncology nurse navigator. They also talked about ways to identify barriers and challenges in navigating breast cancer patients as well as ways to identify and discuss standardized oncology navigation metrics. Susann then talked about her organization’s performance improvement initiative based on navigation metric #10 aimed at increasing patient experience and physician satisfaction.

Thoracic Breakout Session

Using case studies as conversation starters, Wendy Brooks, RN, ONN-CG(T); Amy Jo Pixley, MSN, RN, OCN, ONN-CG; and Katie Brown, OPN-CG, Vice President, LUNGevity Foundation, engaged audience members in a discussion about thoracic navigation best practices, ways to overcome thoracic barriers and challenges, and the importance of identifying and using community outreach and resources to meet patient needs. One thing that they highlighted during this portion of the talk is that the stigma of lung cancer often prevents people from asking for help or support. Navigators need to be aware of this. They then discussed how to institute navigation metrics in thoracic programs and ways to allocate time to meet the needs of the patient as well as the organization.

Genitourinary Breakout Session

During their panel discussion, Frank dela Rama, RN, MS, AOCNS, AGN-BC, Prostate Cancer Nurse Navigator, Palo Alto Medical Foundation, Palo Alto, California, and Angela Young, LSW, American Cancer Society Patient Navigator, Mayo Clinic Cancer Education Center, Rochester, Minnesota, provided an overview of their respective organizations’ genitourinary cancer programs. They then transitioned to an open discussion with attendees about hot topics in genitourinary cancer care, including shared decision-making and prostate cancer genomics.

Complex GI Breakout Session

During the Complex GI Breakout Session, Nicole Messier, RN, BSN, OCN, ONN-CG, a GI/GU Nurse Navigator/Clinical Program Coordinator at the University of Vermont Medical Center, teamed up with Stefani Haar, BS, CPN, an American Cancer Society Patient Navigator at Gundersen Health System in La Crosse, Wisconsin, to cover a variety of topics involving the care of patients with gastrointestinal cancer. This included barriers to care and support services/resources available to patients, particularly those provided by the American Cancer Society. A case study further emphasized the complexity of caring for gastrointestinal cancer patients.

Neuro-Oncology Breakout Session

Managing patients with brain tumors and neurologic complications requires a multidisciplinary approach to care. That was the message delivered during the Neuro-Oncology Breakout Session led by Kellie Koop, RN, BSN, OCN, a Neuro Nurse Navigator with Norton Healthcare. During the session, Kellie discussed the symptoms, risk factors, and various types of brain tumors. Much of the session focused on the management of glioblastoma, including treatment options and management of side effects. Kellie then took a closer look at the oncology nurse navigator 8 core competencies through case reviews of patients with glioblastoma.

Head and Neck Breakout Session

Attendees in the Head and Neck Cancer Breakout Session learned about the challenges, best practices, and importance of nutrition in the care of these complex patients. The panel of speakers included Peg Rummel, RN, MHA, OCN, ONN-CG, Penn Medicine’s Abramson Cancer Center; Audrey Caspar-Clark, MA, RDN, CSO, LDN, Hospital of the University of Pennsylvania; and Jeri Lensing, BA, Mayo Clinic Cancer Education Center. The panel made the point that younger patients and better surgical techniques are changing the landscape of head and neck cancer. Attendees left the session with numerous resources that will help them provide better care for their patients.

The afternoon breakout sessions focused on various other issues related to navigation, including multiple disease/multisite navigators, genomics in cancer screening, patient navigation, biosimilars, and palliative and supportive care.

Multiple Disease/Multisite Navigation

Barbara R. McHale, RN, BS, OCN, CBCN, ONN-CG, Retired Multisite Navigator, Hildegard Medicus Cancer Center at St. Mary’s and Samaritan Hospital, SPHP, Troy, New York, and Elizabeth Glidden, MPH, OPN-CG, American Cancer Society Patient Navigator, The GW Cancer Center, Washington, DC, used their breakout session to talk about the role of the multisite navigator as well as the barriers and challenges that these professionals may encounter at their organizations. They identified standardized metrics that multisite navigators can use to assist them with data collection, documentation, and quality improvement activities. In closing, they shared their case study, “A Day in the Life of Multisite Navigation,” to visually demonstrate the demands of this role.

Role of Cancer Genetics & Genomics

Jennifer R. Klemp, PhD, MPH, MA, Associate Professor of Medicine, Division of Oncology; Co-Program Leader, Cancer Prevention and Survivorship; Director, Cancer Survivorship, University of Kansas Cancer Center, and Founder/CEO, Cancer Survivorship Training, Inc., kicked off this session with a discussion about the role of the navigator in addressing obstacles in integrating cancer genetics and genomics into practices. She also talked about the national accreditation standards involving cancer genetics and genomics. Lavinia Dobrea, MS, RN, OCN, Manager, Oncology Research and Biospecimen Program, St. Joseph Hospital, Orange, California, focused her portion of this session on the challenges that exist in the current case process for tissue collection and case studies illustrating the importance of the navigator in getting patients enrolled in clinical studies. She was followed by Leigha Senter-Jamieson, MS, LGC, Associate Professor, The Ohio State University, Columbus, who talked about germline genetic testing for oncology patients and ways that navigators can incorporate discussions about genetics into their practice.

Integration of Clinical and Nonclinical Patient Navigators

Presentations by Karla Wysocki, MA, CHES, Senior Director, Hospital Systems, American Cancer Society, Rochester, Minnesota, and Janet Gordils-Perez, DNP, ANP-BC, AOCNP, Chief Nursing Officer, Rutgers Cancer Institute of New Jersey, New Brunswick, aimed to empower attendees with the ability to delineate between the roles of nurses and nonclinical patient navigators. They also identified processes to integrate nonclinical patient navigators into health systems to enhance care. Their discussion wrapped up with examples of cross-collaboration between these 2 roles at their respective organizations.

Biosimilars Breakout Session

Biosimilars are engineered medicines that are isolated from a variety of natural sources (aka, biologics), and they may provide multiple benefits to the US healthcare system. During her presentation, Sharon S. Gentry, RN, MSN, CBCN, AOCN, ONN-CG, Novant Health Derrick L. Davis Cancer Center, provided an overview for these medicines and talked about the FDA’s first approved biosimilar for the treatment of cancer in 2017: Mvasi (a biosimilar to Avastin). She shared that biosimilars could promote greater market competition, provide added incentive for investment in this area, and ensure greater patient access.

Integration of Palliative Care and Oncology Nurse Navigation

Palliative care is invaluable in ensuring quality of life, yet it is often underutilized and misunderstood by patients and providers. John R. Himberger, MSN, FNP-BC, ACHPN, Program Coordinator, Palliative Medicine, University of Colorado Southern Region, Memorial Hospital, Colorado Springs, explored the various aspects of palliative care and the stigmas surrounding this service. He shared the results of the ENABLE II study, which demonstrated that palliative care was valuable in promoting quality of life, as well as the ENABLE III study, which found that early initiation of palliative care is optimal for increasing survival. John then focused on the domains of palliative care, the various opportunities for collaboration across specialties when initiating palliative care, and the challenges and strategies of integration.

AONN+ Program Director, Leadership Council Host Town Hall

During the AONN+ Town Hall meeting, Lillie D. Shockney, RN, BS, MAS, ONN-CG, Co-Founder and Program Director of AONN+, provided attendees with a high-level look at the Academy’s progress since the last Annual Conference. Highlights for 2017 include the establishment of several new Local Navigator Networks; the upcoming publication of AONN+’s first textbook, Team-Based Oncology Care: The Pivotal Role of Oncology Navigation, in spring 2018; the addition of partnerships/alliances with Sarah Cannon and the Midwest Cancer Alliance; and the launch of the Assistance for Quality and Research (AQUIRE) Subcommittee (now the Professional Development Committee), which aims to increase members’ involvement as mentors. In 2018, AONN+ will add 4 new committees: Policy and Advocacy, Clinical Trials, Conference Planning, and Membership. The Academy will be opening up its committees for application in early December, thereby putting a formal process in place for committee involvement. Selection for committees will be made in early 2018.

The following individuals were then recognized with AONN+ Annual Awards:

  • Cheryl Bellomo, MSN, RN, OCN, ONN-CG, was presented the AONN+ Ambassador Award
  • Barbara R. McHale, RN, BS, OCN, CBCN, ONN-CG, was presented the AONN+ Outstanding Local Navigator Network Award
  • Tricia Strusowski, MS, RN, was presented the AONN+ Outstanding Committee Award for the Evidence into Practice Metrics Subcommittee

A special AONN+ Lifetime Achievement Award was then presented to Elaine Sein, RN, BSN, CBCN, in recognition of her work to advance both the Academy and the navigation profession.

The Town Hall concluded with a question-and-answer session.

Heroes of Hope Event Under the Stars Honors Singer, Survivor, and Advocate

After a packed day, attendees welcomed the opportunity to kick off their shoes and let loose during AONN+’s Heroes of Hope™ Event Under the Stars. This year’s celebration featured a superhero theme and recognized the 2017 award recipient, Melissa Marshall.

A longtime Atlantic City singer and performer, Melissa was diagnosed with colorectal cancer in 2013. She hasn’t let her diagnosis or subsequent treatment get in the way of her love of performing, though. In fact, she wowed the audience at this year’s event with her anthem, “No you Cant’cer,” which she wrote in the early days of her diagnosis. She also founded a nonprofit foundation by the same name, which raises funds to print and distribute her educational pamphlet, It’s in the Bag. This is used to teach ostomy patients about life with these devices, and helps to dispel the negative myths surrounding their use.

As guests returned to their rooms, tired but very happy after a busy and productive day, many shared how much they had learned at this year’s conference and how much fun it had been. Sunday will bring more educational sessions, poster award presentations, and the closing of the Eighth Annual Conference.

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