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K. Zibrik
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P2.09 - Poster Session/ Nursing and Allied Professionals (ID 227)
- Event: WCLC 2015
- Type: Poster
- Track: Nursing and Allied Professionals
- Presentations: 1
- Moderators:
- Coordinates: 9/08/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P2.09-001 - Triage Nurse Navigator Implementation: Improvements in NSCLC Resource Utilization (ID 414)
09:30 - 09:30 | Author(s): K. Zibrik
- Abstract
Background:
Involvement of nurse navigators (NN) in oncology care is becoming increasingly common to facilitate more timely access to diagnostic services and treatment for patients. A lung cancer NN was implemented at the British Columbia Cancer Agency (BCCA) and this role involved developing pathways for triage and staging investigations, initiating molecular tests and coordinating new patient referrals. In the BC publicly funded health care model, reflex molecular testing is not available. The purpose was to evaluate referral practice, timelines and molecular testing for advanced NSCLC patients in cohorts with and without a triage nurse navigator.
Methods:
The study included all advanced NSCLC patients referred to the BCCA – Vancouver Centre in two separate 1 year cohorts for comparison; 2011 and 2014. Timelines between referral and systemic therapy/radiotherapy (XRT) treatments, availability of molecular testing and data on referral patterns were collected.
Results:
A total of 408 patients were included: 212 in 2011, 196 in 2014. Endpoints for medical oncology (MO) comparing 2011 to 2014: overall referral rates remained the same and the proportion of patients receiving systemic treatment increased, 57% vs 69% (p=0.05). Referral to MO consult 18 d vs 15.5 d (p=0.11), referral to systemic therapy initiation was reduced 48 d vs 38 d (p=0.016). Molecular testing: time from referral to EGFR result was reduced 34 d vs 20 d (p<0.001), EGFR results available at MO consult increased 6% vs 37% (p<0.001), rate of molecular testing increased 62% vs 91% (p<0.001), EGFR mutation positive (19% vs 26% p=0.26). For radiation oncology (RO) endpoints: RO consults 87% vs 80% (p=0.05), the same proportion of patients received XRT (91% vs 87%). Time from referral to RO consult 10 d vs 8 d (p=0.005), referral to XRT 18 d vs 11.5 d (p<0.001).
Conclusion:
Implementation of a NN at triage reduced the time period between referral and treatment for MO and RO. The proportion of patients provided with molecular testing increased and the rate of EGFR positive results remained the same, an indication that more patients received appropriate first line targeted therapy. Nurse navigator participation during triage activities suggests that physician, diagnostic and clinical resources are more appropriately allocated.
