Development of a workflow process mapping protocol to inform the implementation of regional patient navigation programs in breast oncology
BACKGROUND Implementing city‐wide patient navigation processes that support patients across the continuum of cancer care is impeded by a lack of standardized tools to integrate workflows and reduce gaps in care. The authors present an actionable workflow process mapping protocol for navigation proce...
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Published in | Cancer Vol. 128; no. S13; pp. 2649 - 2658 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
Wiley Subscription Services, Inc
01.07.2022
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Subjects | |
Online Access | Get full text |
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Summary: | BACKGROUND
Implementing city‐wide patient navigation processes that support patients across the continuum of cancer care is impeded by a lack of standardized tools to integrate workflows and reduce gaps in care. The authors present an actionable workflow process mapping protocol for navigation process planning and improvement based on methods developed for the Translating Research Into Practice study.
METHODS
Key stakeholders at each study site were identified through existing community partnerships, and data on each site's navigation processes were collected using mixed methods through a series of team meetings. The authors used Health Quality Ontario's Quality Improvement Guide, service design principles, and key stakeholder input to map the collected data onto a template structured according to the case‐management model.
RESULTS
Data collection and process mapping exercises resulted in a 10‐step protocol that includes: 1) workflow mapping procedures to guide data collection on the series of activities performed by health care personnel that comprise a patient's navigation experience, 2) a site survey to assess program characteristics, 3) a semistructured interview guide to assess care coordination workflows, 4) a site‐level swim lane workflow process mapping template, and 5) a regional high‐level process mapping template to aggregate data from multiple site‐level process maps.
CONCLUSIONS
This iterative, participatory approach to data collection and process mapping can be used by improvement teams to streamline care coordination, ultimately improving the design and delivery of an evidence‐based navigation model that spans multiple treatment modalities and multiple health systems in a metropolitan area. This protocol is presented as an actionable toolkit so the work may be replicated to support other quality‐improvement initiatives and efforts to design truly patient‐centered breast cancer treatment experiences.
LAY SUMMARY
Evidence‐based patient navigation in breast cancer care requires the integration of services through each phase of cancer treatment.
The Translating Research Into Practice study aims to implement patient navigation for patients with breast cancer who are at risk for delays and are seeking care across 6 health systems in Boston, Massachusetts.
The authors designed a 10‐step protocol outlining procedures and tools that support a systematic assessment for health systems that want to implement breast cancer patient navigation services for patients who are at risk for treatment delays.
A workflow mapping protocol is designed to support health systems plan for the implementation of a breast cancer patient navigation program to support patients across multiple treatment modalities. This tool may be used to disseminate evidence‐based navigation in oncology care. |
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Bibliography: | We thank and gratefully acknowledge the support of partnering organizations that share a commitment to reducing disparities and the American Cancer Society for their dedication to patient navigation and the National Navigation Roundtable (NNRT). The National Navigation Roundtable is a collaboration of navigation stakeholders and field experts, dedicated to establishing patient navigation as a recognized and valued part of the health care system to assure optimal health outcomes for cancer patients. Thank you to the steering committee of the NNRT for helping lead the direction of this supplement and the hundreds of organizations and patient navigators who provided input and time to help inform this supplement. The members of the Translating Research Into Practice (TRIP) Consortium include the following: Beth Israel Deaconess Medical Center (Ted A. James MD; Susan McCauley RN; Ellen Ohrenberger RN, BSN; JoEllen Ross RN, BSN; and Leo Magrini BS), the Boston Breast Cancer Equity Coalition Steering Committee (Susan T. Gershman MS, MPH, PhD, CTR; Mark Kennedy MBA; Anne Levine Med, MBA; and Erica T. Warner ScD, MPH), Brigham and Women's Hospital (Cheryl R. Clark MD, ScD), Boston Medical Center (William G. Adams MD; Sharon Bak MPH; Tracy A. Battaglia MD, MPH; Nicole Casanova BA; Janice Debrito BA; Katie Finn BA; Christine Gunn PhD; Jackeline Hernandez AAS; Naomi Y. Ko MD; Ariel Maschke MA; Katelyn Mullikin BA; Laura Ochoa BA; Charlotte Robbins BS; Christopher W. Shanahan MD, MPH; Samantha Steil BA; and Victoria Xiao BS), Boston University (Howard J. Cabral PhD, MPH; Clara Chen MHS; Carolyn Finney BA; Christine Lloyd‐Travaglini MPH; and Stephanie Loo MSc), Dana‐Farber Cancer Institute (Magnolia Contreras MSW, MBA; Rachel A. Freedman MD, MPH; Yoscairy Raymond BSW, CCHW; and Deborah Toffler MSW, LCSW), Dana‐Farber /Harvard Cancer Center (Karen Burns White MS), Equal Hope (Anne Marie Murphy PhD), Massachusetts General Hospital (Carmen Benjamin MSW; Beverly Moy MD; Jennifer S. Haas MD, MPH; Caylin Marotta MPH; Aileen Navarrete BA; Mira Oravcova‐Mejia MEd; Sanja Percac‐Lima MD, PhD; Emma Whited BA; and Amy J. Wint MSc), Tufts Medical Center (Karen M. Freund MD, MPH; William F. Harvey MD, MSc; Danielle Krzyszczyk BA; Amy M. LeClair PhD; MPhil; Susan K. Parsons MD, MRP; Dolma Tsering BS; and Feng Qing Wang BA), the University of Massachusetts Lowell (Serena Rajabiun MA, MPH, PhD), and the University of Massachusetts Medical School (Stephenie C. Lemon PhD). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Karen M. Freund– conceptualization, funding acquisition, methodology, project administration, resources, supervision, validation, writing –review, editing Rachel A. Freedman – conceptualization, resources, validation, writing-review, editing Katelyn R. Mullikin – writing – review, editing Nicole L. Casanova – conceptualization, methodology, writing – original draft, writing- review, editing, project administration Jennifer S. Haas– conceptualization, funding acquisition, methodology, project administration, resources, supervision, validation, writing –review, editing Victoria Xiao – writing – review, editing Stephenie C. Lemon – conceptualization, funding acquisition, methodology, project administration, resources, supervision, validation, writing –review, editing Author Contributions Amy M. LeClair – conceptualization, methodology, writing – review, editing Tracy A. Battaglia– conceptualization, funding acquisition, methodology, project administration, resources, supervision, validation, writing –review, editing |
ISSN: | 0008-543X 1097-0142 |
DOI: | 10.1002/cncr.33944 |