Available online 22 March 2024, 151589

Author links open overlay panel, , AbstractObjectives

To offer a comprehensive overview of the critical elements contributing to the achievements of oncology navigation, address challenges in standardized implementation, and examine recent advancements influencing the acknowledgment and reimbursement of navigation services. Lastly, the AONN+ 35 evidence-based navigation metrics will be shared, emphasizing the five core metrics that should be utilized by all navigation models in all settings.

Methods

Employed in this review involves synthesizing information from established oncology organizations, documenting the development of navigator professional standards of practice and navigation metrics that measure patient experience, clinical outcomes, and return on investment, and analyzing outcomes from national studies and collaborations to present a summary of advancements in oncology navigation.

Results

The key components vital for ensuring the enduring success of programs encompass the core competencies of navigators, adherence to standards of navigation practice set by the Professional Oncology Navigation Taskforce, and the establishment of well-defined metrics specific to oncology navigation.

Conclusions

Despite these advancements, challenges persist in implementing and recognizing the newly defined standards and metrics. Effective solutions involve aligning navigation programs with leadership, integrating standards into daily practice, defining navigator roles, measuring navigation program outcomes through defined metrics, and leveraging certifications. Standardized measurement and practice are imperative for national policy development and reimbursement models, aligning with the Cancer Moonshot's goal of high-quality, patient-centered, and cost-effective cancer care.

Implications for Nursing Practice

To contribute to standardizing measurement and practice in oncology navigation for national policy development and reimbursement models.

Section snippetsNavigation Standards Development

In July 2018, a multidisciplinary group of professional navigation thought leaders convened through the Biden Cancer Initiative (BCI) to address the gap in implementing patient navigation programs across the United States. The BCI Patient Navigation Work Group recognized that although navigation programs have grown significantly over the past decade, fundamental challenges remain with the standardized implementation of navigation. This created barriers to demonstrating the value and impact of

Navigation Metric Development

A standardized measurement system is also critical for professional navigation practice to aid in program development and allow benchmarking across programs and settings. Evidence supports that there is a need for consistency in navigation measurement.9 The Institute of Medicine published the report Ensuring Quality Cancer Care, which recommends that quality care be measured using a set of core measures.10 Implementation of standardized metrics will provide a mechanism for program

Value-Based Cancer Care and Reimbursement for Navigation Services

Value-based cancer care aims to provide high-quality, patient-centered care while reducing the cost of care for oncology patients. Navigation programs have struggled with how to cover the costs of staff, and the Centers for Medicare and Medicaid Services has codes that can account for the resources involved in a multidisciplinary team of clinical staff and other auxiliary personnel furnishing services.

In November 2023, the American Medical Association released current procedural terminology on

Case Study

A cancer navigation site focused on creating a standard process and pathway to gather patient distress screening data. The distress screenings were initially administered during the first medical oncology visit. The PI project was testing whether it made sense to provide the screening at the second medical oncology visit. The team purchased iPads to enable patients to complete the screening independently. The data were transmitted immediately to the hospital EHR, and the nurses could review the

Conclusions

Cancer programs interested in having a navigation service now have the key tools for designing their navigation program: the professional practice standards, competencies, knowledge domains, and metrics. The navigation model must include the foundational principles of navigation to address barriers to care and facilitate timely access to treatment. The navigation program must establish core program metrics that serve as baseline metrics for program performance and improvement and core measures

Author Contributions

DJ: Conceptualization; Data curation; Formal analysis; Investigation; Project administration; Resources; Validation; Visualization; Writing—original draft; Writing—review and editing; Writing—approval of final version. BN: Conceptualization; Data curation; Formal analysis; Investigation; Project administration; Resources; Validation; Visualization; Writing—original draft; Writing—review and editing; Writing—approval of final version. TS: Conceptualization; Data curation; Formal analysis;

CRediT authorship contribution statement

Tricia Strusowski: Writing – original draft. Danelle Johnston: Writing – original draft. Brenda Nevidjon: Writing – original draft.

Declaration of competing interest

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Brenda Nevidjon reports a relationship with Oncology Nursing Society that includes: employment. Tricia Strusowski MS, RN reports writing assistance was provided by Oncology Nursing Society. Tricia Strusowski reports a relationship with Oncology Nursing Society that includes: non-financial support. If there are other authors, they declare that they have no known

Funding

The research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

References (18)R. Crane-OkadaEvaluation and outcome measures in patient navigation

Semin Oncol Nurs

(2013)

Oncology Nurse Navigator Core Competencies. Oncology Nursing Society. 2017. Available at:...P. Valverde et al.Findings from the National Roundtable Training and Certification Task Group: a call for standardization of patient navigation training

Cancer

(2019)

E. Franklin et al.Oncology navigation standards of professional practice

J Oncol Navig Surviv

(2022)

P Strusowski et al.Standardized evidence-based oncology navigation metrics for all models: a powerful tool in assessing the value and impact of navigation program

J Oncol Nurs Surviv

(2017)

Cancer facts and figures 2023. American Cancer Society. Available at:...C. DavisThe importance of professional standards

Nursing Made Incredibly Easy!

(2014)

The Nursing Scopes and Standards of Practice. Available at:...Practice Standards & Guidelines. Available at: https://www.socialworkers.org/Practice/Practice-Standards-Guidelines....

There are more references available in the full text version of this article.

View full text

© 2024 Published by Elsevier Inc.