The effect of nurse navigation on timeliness of breast cancer care at an academic comprehensive cancer center

• Published in: Cancer 2013-07, Vol.119 (14), p.2524-2531
• Main Authors: Basu, Mohua, Linebarger, Jared, Gabram, Sheryl G. A., Patterson, Sharla Gayle, Amin, Miral, Ward, Kevin C.
• Format: Article
• Language: English
• Subjects: Academic Medical Centers; Adult; Age Factors; Aged; Biological and medical sciences; breast cancer; Breast Neoplasms - diagnosis; Breast Neoplasms - therapy; delivery of care; Disease Management; Female; Georgia; Gynecology. Andrology. Obstetrics; Health Services Accessibility; Humans; Insurance, Health; Linear Models; Mammary gland diseases; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoplasm Grading; Neoplasm Staging; Nurse's Role; patient navigation; Patient Navigation - standards; quality of care; Referral and Consultation; Registries; Retrospective Studies; Seasons; Social Class; Time-to-Treatment - organization & administration; Time-to-Treatment - standards; Tumors
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.28024

BACKGROUND A patient navigation process is required for accreditation by the National Accreditation Program for Breast Centers (NAPBC). Patient navigation has previously been shown to improve timely diagnosis in patients with breast cancer. This study sought to assess the effect of nurse navigation on timeliness of care following the diagnosis of breast cancer by comparing patients who were treated in a comprehensive cancer center with and without the assistance of nurse navigation. METHODS Navigation services were initiated at an NAPBC‐accredited comprehensive breast center in July 2010. Two 9‐month study intervals were chosen for comparison of timeliness of care: October 2009 through June 2010 and October 2010 through June 2011. All patients with breast cancer diagnosed in the cancer center with stage 0 to III disease during the 2 study periods were identified by retrospective cancer registry review. Time from diagnosis to initial oncology consultation was measured in business days, excluding holidays and weekends. RESULTS Overall, 176 patients met inclusion criteria: 100 patients prior to and 76 patients following nurse navigation implementation. Nurse navigation was found to significantly shorten time to consultation for patients older than 60 years (B = −4.90, P = .0002). There was no change in timeliness for patients 31 to 60 years of age. CONCLUSIONS Short‐term analysis following navigation implementation showed decreased time to consultation for older patients, but not younger patients. Further studies are indicated to assess the long‐term effects and durability of this quality improvement initiative. Cancer 2013;119:2524–2531. © 2013 American Cancer Society. Nurse navigation was found to significantly shorten time to consultation for breast cancer patients older than 60 years. Further studies are indicated to assess the long‐term effects and durability of this quality improvement initiative.