Healthcare executive Rani Khetarpal released an episode of her Value-Based Care Perspectives Podcast that features an interview with Billie Lynn Allard, clinical nurse specialist and author of Inspired Healthcare: A Value-Based Care Coordination Model, and Lillie Shockney, administrative director of the Johns Hopkins Breast Center. In the episode, Allard and Shockney share insights about the history and development of oncology navigation, explain why navigation often fails, and describe easy-to-implement tactics and strategies for making it more successful. They also share the ongoing work of the Academy of Oncology Nurse and Patient Navigators (AONN+).
Listen to the full Value-Based Care Perspectives Podcast episode.
What Is Oncology Navigation?
Shockley explains that navigation is the process of bringing a patient through every phase of their treatment, from pre-diagnosis through survivorship. “During that time, navigation and navigators need to be focusing on identification of barriers to care and barriers to treatment,” she says.
Navigation began in the 1970s as simple review of medical records, but has evolved since then to include improved documentation, better physician-patient communication, and advocacy for patients. The goal is to get patients the right care with the right justification and the right payment at the right time by removing or navigating around any barriers to that care.
Initially, oncology navigation started with breast cancer patients, but in the mid-1990s it began to expand, and now covers all major forms of cancer.
Through The Patient’s Eyes
As a clinical nurse specialist, Allard spent years lamenting how broken the healthcare system was. As everyone tried to push accountability and payment onto everyone else to avoid fees, no one seemed to care whether patients actually got the care they needed. The solution? Adopt the practices of oncology navigation in clinical nursing.
“We took really clinically excellent nurses, and we partnered them with four to five primary care practices and chose the patients that cost a lot of money that were constantly coming in and out of the hospital,” Allard shares. “We navigated with them across the health system and kind of began for the first time in our careers, seeing the experience of healthcare delivery through the patient and the family's eyes. And we put together a gap analysis of what things really needed to be fixed.”
The biggest issue, they found, was over complication. Simple solutions, simple instructions, simple concepts like colored refrigerator magnets to remind patients which medicines to take--the simpler they could make care for patients, the better those patients would respond
The Academy of Oncology Nurse and Patient Navigation (AONN+)
AONN+ was founded in 2009 and has over 9,000 members. One of its primary tasks is to train and certify oncology nurse navigators via a comprehensive program and exam, which was recently accredited both nationally and internationally. The Commission on Cancer also recently recognized the AONN+ Foundation for Learning’s oncology nurse navigation certification as a program they would endorse.
And as nurse navigation expands beyond oncology, AONN+ will be a model for navigation outside of the oncology realm. Plans are already taking shape to develop navigation training resources for other illnesses, including congestive heart failure, diabetes, and more.
“It would have a very similar layout of what we have accomplished for oncology nurse navigators, but looking at newbies and how to train them, those that are relatively seasoned, those that are experts having tracks, having conferences every year, and having membership so that they can learn from one another within their specialty so that they can learn the grassroots and not have to reinvent the wheel,” says Shockney.
About:
Rani Khetarpal is an award-winning Healthcare Executive with a depth of experience in healthcare delivery and pharmaceuticals with proven leadership across commercial strategy, market development, and strategic partnerships. Rani has demonstrated an ability to successfully deliver positive results in new and changing environments, focused on outcomes driven by value-based care. With a core emphasis in oncology and post-acute care, Rani is fluent in the impact payment models and care delivery models for all members of the healthcare ecosystem. With an entrepreneurial mindset, Rani continues to successfully guide and implement internal strategies and innovative business models that optimize profitability and quality of care. Connect with Healthcare executive Rani Khetarpal on https://www.linkedin.com/in/ranikhetarpal/
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