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Navigating patients through breast cancer

Getting where you need to go has never been easier. With Internet mapping programs and personal navigation systems, everyone has a guide to take them into the unknown. And, now patients at Virtua get navigators to guide them through the turns of breast cancer.

“After a suspicious mammogram or cancer diagnosis, patients are in shock and don’t know where to turn,” says Lisa Shalkowski, RN, BSN, director of the Virtua breast care program. “Navigators make an overwhelming process manageable by coordinating care and supporting women along the way.”

With more than 60 steps in a patient’s journey from the time she receives an abnormal mammogram to the beginning of treatment, it’s no wonder the response to the Breast Care Navigation Program has been so positive.

Results from the pilot program show that 90 percent of patients choose to continue their care at Virtua, compared to 50 percent before the program began.

Planning a route
Barbara Francks, RN, and Pauline Sundell, RN, are Virtua nurse navigators.Together, they’ve guided nearly 100 patients through the system since the pilot began last July. “Navigators empower patients by providing personalized education and support from the first test through treatment, recovery and beyond,” says Francks.

When a patient has an abnormal mammogram, her gynecologist alerts the access navigator, who calls the patient to review options and expedite an appointment with a specialist.

If the specialist diagnoses breast cancer, the patient is assigned a nurse navigator who, within 48 hours, calls the patient to answer questions, make appointments and coordinate insurance.The navigator stays in contact during the patient’s entire course of clinical care.

“Supporting the patient is one part of the job,” adds Sundell. “We are also a crucial liaison between the patient and the breast care team, which includes the surgeon, medical oncologist, radiation oncologist and social worker, as well as her primary care and referring physicians.”

Behind the scenes
Developing the navigation process required months of research by a Six Sigma team who examined each step in the continuum of breast cancer care.They surveyed physicians and patients to streamline services. Virtua’s information services designed a secure database to provide the care team with real-time patient information.The system includes “smart features” such as patient itineraries, task lists and reminders at key checkpoints.

The positive feedback and patient and physician satisfaction scores have led the way to expand the program to all Virtua breast specialists. “The program ensures comprehensive, coordinated care from the start,” says Francks. “It’s another example of how Virtua provides an outstanding patient experience.”