11/7/2013 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 [email protected] Good Help to Those in Need. ® 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 Good Help to Those in Need. ® Bon Secours St Mary’s Hospital Good Help to Those in Need. ® 1 11/7/2013 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) Good Help to Those in Need. ® 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. Good Help to Those in Need. ® Defining Navigator Program Goal of the program Key stakeholders Organization/patient needs Good Help to Those in Need. ® 2 11/7/2013 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 Good Help to Those in Need. ® Key stakeholders Patient, family members, and community Physician buy in Physician Champion Administration buy in Return On Investment Good Help to Those in Need. ® Organizational/Patient needs Expectations from providers Expectations from administration Patient demographics Good Help to Those in Need. ® 3 11/7/2013 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 Good Help to Those in Need. ® Good Help to Those in Need. ® Metric Selection Meaningful Reliable Feasible Understandable Evidenced Based Good Help to Those in Need. ® 4 11/7/2013 Outcome Metrics Timeliness to care Referrals to ancillary services Retained patients Patient satisfaction Catholic Health Initiatives, 2013 Good Help to Those in Need. ® 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 Good Help to Those in Need. ® 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 Good Help to Those in Need. ® 5 11/7/2013 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 Good Help to Those in Need. ® 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 Good Help to Those in Need. ® Demonstrating value Increased volume and revenue Increased patient & provider satisfaction Reduced time from abnormal screening to diagnosis Earlier stage at diagnosis Reduced outmigration Good Help to Those in Need. ® 6 11/7/2013 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 Good Help to Those in Need. ® 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 Good Help to Those in Need. ® “Alone we can do so little; together we can do so much.” Helen Keller Good Help to Those in Need. ® 7 11/7/2013 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. ® 8