Tag Archives: patient navigation metrics

Navigation Metrics & Value-Based Care: Measuring Up

By Tricia Strusowski, RN, MSN

Compass pointing at answers-SMALLAs the move to value-based care and Alternative Payment Models (APMs) continues, oncology patient navigators need to become more business savvy and have a full understanding about value-based cancer care metrics.  Case in point: Medicare’s Oncology Care Model (OCM) pilot, the first oncology-specific alternative payment model developed by the Center for Medicare and Medicaid Innovation (CMMI). Data collection and reporting metrics are integral elements of this five-year pilot program, which seeks to achieve higher quality, more highly coordinated care, and smarter spending.

The challenge: Navigation programs lacked strong evidence-based metrics to demonstrate the impact of navigation on the key areas of quality, coordination, and cost-effectiveness.

The good news: the Academy of Oncology Nurse & Patient Navigators (AONN+) recently released 35 evidenced-based metrics in the key categories of patient experience, clinical outcomes, and return on investment.

These metrics were developed using the AONN+  evidence-based Navigation General Certification Domains:

  • Community Outreach and Prevention
  • Coordination of Care/Care Transitions
  • Patient Advocacy/Patient Empowerment
  • Psychosocial Support Services/Assessment
  • Survivorship/End of Life
  • Professional Roles and Responsibilities
  • Operations Management/Organizational Development/Healthcare Economics
  • Research and Quality Performance Improvement

The metrics were developed so that any cancer program or practice can utilize them regardless of the navigation model in place.  The goal in providing these standard metrics is for cancer programs and practices to use them “as a baseline to prove the efficacy and sustainability of their [navigation] programs.”1 Learn more and access metrics.

Partnering to Advance Value-Based Cancer Care
As oncology providers work to improve care coordination and demonstrate delivery of patient-centered, efficient, quality care, patient navigators can play an important role in establishing connections by partnering with physician practices.

For example, navigators can integrate with physician practices to:

  • Increase efficiency and timely access to services by providing comprehensive assessments and referrals to appropriate disciplines
  • Reinforce patient education and empowerment through decision aids and patient appointment checklists
  • Create standing order sets, physician profiles, pathways, and guidelines
  • Increase support for clinicians, i.e., provide early discussions about palliative care, goals of care, advance care planning, and pre-habilitation
  • Increase contacts with “frequent flyers” to decrease ER visits and avoidable admissions
  • Provide automatic referrals to financial counseling at time of diagnosis (generate self-referral reports)

On Thursday, March 30, I will present a more in-depth look at the potential for “Creating Partnerships Between Oncology Nurse Navigators & Oncology Practices” in a session at the ACCC 43rd Annual Meeting, CANCERSCAPE.  The oncology landscape continues to evolve at a rapid pace.  I believe now is the time to explore how navigators can support value-based care initiatives with physician practices, as we all work to keep patients at the center of care delivery.

I hope to see you at CANCERSCAPE, March 29-31, 2017, in Washington, D.C.

Reference

1 Strusowski T, Sein E, Johnston D. Academy of Oncology Nurse & Patient Navigators Announces Standardized Navigation Metrics. J Oncol Nav Survivorship. 2017; 8(2):62-68.

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ACCC member Tricia Strusowski, RN, MSN, is a consultant with Oncology Solutions, LLC, with 20 years of experience in patient navigation.

Navigation Metrics and Value-Based Care

By Tricia Strusowski, MS, RN

Ms. Strusowski recently co-authored an article on “Patient Navigation Metrics” for Oncology Issues, the journal of the Association of Community Cancer Centers. In this guest blog post, she explores this topic in the context of value-based care.

ThinkstockPhotos-467463476Value-based care is a highly coordinated, patient-centered solution to address rising costs, duplication of services, barriers to care, and to help patients receive the care they need. Over the decades, patient navigation standards and core competencies have been established through national organizations. These guidelines and standards have provided an excellent foundation for oncology navigation programs. Metrics are exceedingly important for measuring the success of your patient navigation program. Value-based care (which drives improvements to the delivery of care by requiring improved care at a lower cost) encompasses more than metrics and has the potential to skyrocket your program to a new level.

As we advance present navigation programs, value-based care will be essential; it will incorporate all the key categories from the Institute of Medicine (IOM) report, “Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis.”

The conceptual framework from the IOM report includes:

  • Engaged patients
  • Adequately staffed, trained, and coordinated workforce
  • Evidence-based cancer care
  • A learning healthcare IT system for cancer
  • Translation of evidence into clinical practice, quality measurement, and performance improvement
  • Accessible, affordable cancer care

The goal of value-based care is to empower patients to actively participate in their care, which will enhance the patient experience and drive patient-centered outcomes.

How can we support our patients to participate in their care discussions? Some examples include:

  • Provide decision aides including questions to prompt discussion with the patient and his or her healthcare provider
  • Provide patients with educational information that incorporates their preferred learning style, i.e., written, visual, or verbal
  • Mandate health literacy and cultural competency training for our staff
  • Utilize evidence-based tools to identify barriers for patients and their families
  • Create a patient appointment checklist to explain the reason for tests and procedures

The result of value-based care is a patient-centered process in which patients and their families are educated and able to participate in their treatment discussion from time of diagnosis through to survivorship or end-of-life services. By having our patients actively participate in these treatment discussions, value-based outcomes will prevail and advance the level of our patient navigation programs.

Next week, the ACCC 42nd Annual Meeting, CANCERSCAPE, in Washington, D.C., will feature sessions that focus on various facets of value-based care, including a special Town Hall discussion: Value Framework Tools: The Provider Perspective, which will be live-streamed on Thursday, March 3, 2016, from 12:50 pm — 1:35 pm EST. Learn more here.