1. Good Help to Those in Need. ® 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

2. 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

3. Good Help to Those in Need. ® Bon Secours St Mary’s Hospital

4. Good Help to Those in Need. ® 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)

5. 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.

6. Good Help to Those in Need. ® Defining Navigator Program  Goal of the program  Key stakeholders  Organization/patient needs

7. Good Help to Those in Need. ® 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

8. Good Help to Those in Need. ® Key stakeholders  Patient, family members, and community  Physician buy in  Physician Champion  Administration buy in  Return On Investment

9. Good Help to Those in Need. ® Organizational/Patient needs  Expectations from providers  Expectations from administration  Patient demographics

10. Good Help to Those in Need. ® 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

11. Good Help to Those in Need. ®

12. Metric Selection  Meaningful  Reliable  Feasible  Understandable  Evidenced Based

13. Good Help to Those in Need. ® Outcome Metrics  Timeliness to care  Referrals to ancillary services  Retained patients  Patient satisfaction Catholic Health Initiatives, 2013

14. 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

15. 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

16. Good Help to Those in Need. ® 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

17. 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

18. 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

19. Good Help to Those in Need. ® 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

20. 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

21. Good Help to Those in Need. ® “Alone we can do so little; together we can do so much.” Helen Keller “Alone we can do so little; together we can do so much.” Helen Keller

22. Good Help to Those in Need. ® 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/0-10000000/0- 10000/1338/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/Advisory- com/Research/OR/Research-Study/2011/Maximizing-the-Value-of-Patient- Navigation/Maximizing-the-Value-of-Patient-Navigation.pdf