The Dollars and $ense of
Navigation:
How to quantify your role
Donna Moore Wilson, BSN, RN, CBCN
Oncology Nurse Navigator
Bon Secours St. Mary’s Hospital
Richmond, Virginia
Donna_Moore-Wilson@bshsi.org
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Objectives
Defining the role of the navigator
 Choosing appropriate navigation metrics
to justify the role
Developing a plan to demonstrate
navigation’s value and return on
investment
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Bon Secours St Mary’s Hospital
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Mission of the Navigator
Provide a resource for cancer patients to
assist them in navigating through the
complex healthcare environment & around
any barriers to timely care which might
exist…
Bon Secours Cancer Institute (2006)
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Bon Secours Navigation Goal
Improve communication between patients,
providers, and caregivers
Connect patients with community
resources
Collaborate across the medical team on all
aspects of cancer care from diagnosis,
treatment and survivorship.
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Defining Navigator Program
Goal of the program
Key stakeholders
Organization/patient needs
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Goal of the program
Decide on model that is most compatible
for organization and patient population
served
Tumor Site
Patient Entry Point
RN, Social Worker, Community Health
Worker, Lay person/survivor
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Key stakeholders
Patient, family members, and community
Physician buy in
Physician Champion
Administration buy in
Return On Investment
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Organizational/Patient needs
Expectations from providers
Expectations from administration
Patient demographics
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Navigation Role
 Outreach
Education/Prevention
Early Detection/Access to Care
 Diagnosis/Treatment
Time of abnormal finding, diagnosis, treatment
Barriers, concerns issues arise
 Survivorship
Summary/Care Plan
QOL issues
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Metric Selection
Meaningful
Reliable
Feasible
Understandable
Evidenced Based
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Outcome Metrics
Timeliness to care
Referrals to ancillary services
Retained patients
Patient satisfaction
Catholic Health Initiatives, 2013
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Metric Recommendations
Disease site/staging at time of diagnosis
Target is to increase early stage diagnosis
Referral source
Timeliness to care
National benchmarks can be used as
reference (breast, lung, colorectal, head &
neck)
Catholic Health Initiatives, 2013
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Navigator Productivity Indicators
 Patient volumes
Initial, ongoing, and surveillance/survivorship
Number of barriers to care identified
Number of referral needs for barrier migration
Time spent making referrals
Patient acuity level
Catholic Health Initiatives, 2013
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Navigator Productivity Indicators
Patient satisfaction
Retention (decrease outmigration &
subsequent revenue = downstream revenue)
Navigator impact on treatment adherence
(revenue capture)
Referral to services
Can demonstrate downstream revenue
Catholic Health Initiatives, 2013
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Navigator Productivity Indicators
Provider Satisfaction
Outcome metrics
Timeliness to care
Coordination/continuity of care
Collaboration with addressing patient
concerns
Quality of patient education
Catholic Health Initiatives, 2013
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Demonstrating value
Increased volume and revenue
Increased patient & provider satisfaction
Reduced time from abnormal screening to
diagnosis
Earlier stage at diagnosis
Reduced outmigration
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Demonstrating value
Adherence to treatment appointments/
reduced no-show rates
Resolution of patient’s barrier to care
Reduced emergency visits
Shortened hospital readmissions
Improved coordination of care
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Conclusion
 Navigation is an unreimbursed service
Administration faced with pressure to quantify
benefits of navigation
 Critical to track revenues from new or returned
patients who were attracted by the program’s
navigation services
 Vital to track navigation-specific patient
satisfaction.
2011 The Advisory Board Company
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“Alone we can do so little; together we can do so much.”
Helen Keller
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References
Bon Secours Cancer Institute. (2006). Oncology patient navigation program.
Retrieved November 5, 2008, from Bon Secours Richmond Health System.
Catholic health initiatives. Navigation program resource guide: Best practices
for patient navigation programs. (2013). Retrieved August 3, 2013 from
http://navigator.vc.ons.org/file_depot/0-10000000/010000/1338/folder/8022/CHI+Navigation+Program+Resource+Guide+(Outsi
de+CHI+Version+0413).pdf
Oncology roundtable, the advisory board company. Maximizing the value of
patient navigation: lessons for optimizing program performance. (2011).
Retrieved August 5, 2013 from http://www.advisory.com/~/media/Advisorycom/Research/OR/Research-Study/2011/Maximizing-the-Value-of-PatientNavigation/Maximizing-the-Value-of-Patient-Navigation.pdf
Good Help to Those in Need. ®