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ONCOLOGY NAVIGATION DECREASES TIME TO TREATMENT IN PATIENTS WITH PANCREATIC MALIGNANCY
Laura Enomoto*1, Joyce Fenstermaker1, Rodwige Desnoyer2, Boris Pasche2, Arthur W. Blackstock3, Russell Howerton1, Clancy J. Clark1, Edward Levine1, Perry Shen1
1Surgery, Wake Forest Baptist Medical Center, Winston Salem, NC; 2Medicine, Wake Forest Baptist Medical Center, Winston Salem, NC; 3Radiology, Wake Forest Baptist Medical Center, Winston Salem, NC
Background and Objectives: The care of pancreatic cancer patients has become increasingly complex, which has led to delays in the initiation of therapy. Nurse navigators have been added to care teams, in part, to ameliorate this delay. This study investigated the difference in time from first oncology visit to first treatment date in patients with pancreatic malignancy before and after the addition of an Oncology Navigator.
Methods: A single institution database of patients at a tertiary referral center diagnosed with any pancreatic malignancy who were evaluated by a provider in Radiation Oncology, Medical Oncology or Surgical Oncology between October 1, 2015 and September 1, 2017 was analyzed. After October 1, 2016, an Oncology Navigator met patients at their initial oncology visit, offered resources, and coordinated care throughout treatment. The cohort was divided into two groups: patients who were evaluated prior to the implementation of an Oncology Navigator and patients evaluated after implementation. Patient demographics and time from first oncology visit to first treatment (radiation, chemotherapy or surgery) were compared.
Results: One hundred thirty six new patients with a new diagnosis of pancreatic malignancy were evaluated. Fifty-six patients were seen prior to the start of the Oncology Navigator and 80 were evaluated after the nurse navigation program was implemented. Twenty-seven patients were removed from analysis because they were already receiving treatment and were seen as a second opinion. The mean age in both cohorts was 68. There were more men (64.3%) and patients of white race (56.6%). Mean days from first visit to first treatment without an Oncology Navigator was 42 days, but with an Oncology Navigator it was 29 days. This 13 day difference was significant (p = 0.04).
Conclusions: Implementing a nurse navigation program significantly decreases the time to treatment in patients with pancreatic malignancy. Future studies investigating the role of the Oncology Navigator in coordinating care and as well as enrollment in supportive care services should be undertaken.
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