Benefits, Cost, and Activities of Patient Navigation (PN) Program for Colorectal Cancer Screening at the Charles B. Wang Community Health Center (CBWCHC)

Qian, Feng; Gates, Margaret A.; Bisner, Sharon; Collins, Elisè; Vora, Shalini; Dacus, Heather

doi:10.1007/s10903-019-00913-6

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…CPN programs increase access to vital services for patients with cancer, help distribute work among busy oncology care teams, and can improve patient outcomes. 29 Navigation has been shown to improve patient satisfaction while also demonstrating financial benefits for cancer programs. Therefore, these programs may continue to grow.…”

Section: Discussionmentioning

confidence: 99%

Derivation of a Unique, Algorithm-Based Approach to Cancer Patient Navigator Workload Management

Zhu,

Zhang,

Kang

et al. 2023

JCO Clinical Cancer Informatics

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PURPOSE Cancer patient navigators (CPNs) can decrease the time from diagnosis to treatment, but workloads vary widely, which may lead to burnout and less optimal navigation. Current practice for patient distribution among CPNs at our institution approximates random distribution. A literature search did not uncover previous reports of an automated algorithm to distribute patients to CPNs. We sought to develop an automated algorithm to fairly distribute new patients among CPNs specializing in the same cancer type(s) and assess its performance through simulation on a retrospective data set. METHODS Using a 3-year data set, a proxy for CPN work was identified and multiple models were developed to predict the upcoming week's workload for each patient. An XGBoost-based predictor was retained on the basis of its superior performance. A distribution model was developed to fairly distribute new patients among CPNs within a specialty on the basis of predicted work needed. The predicted work included the week's predicted workload from a CPN's existing patients plus that of newly distributed patients to the CPN. Resulting workload unfairness was compared between predictor-informed and random distribution. RESULTS Predictor-informed distribution significantly outperformed random distribution for equalizing weekly workloads across CPNs within a specialty. CONCLUSION This derivation work demonstrates the feasibility of an automated model to distribute new patients more fairly than random assignment (with unfairness assessed using a workload proxy). Improved workload management may help reduce CPN burnout and improve navigation assistance for patients with cancer.

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Section: Discussionmentioning

confidence: 99%

Derivation of a Unique, Algorithm-Based Approach to Cancer Patient Navigator Workload Management

Zhu,

Zhang,

Kang

et al. 2023

JCO Clinical Cancer Informatics

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“…Research studies indicate through PN, patients have a reliable resource that focuses on their needs, and medical staff have professionals who coordinate appointments and educate patients about treatments. 12 PNs act as a liaison between the cancer patient and medical professionals, which improves patient-provider communication and relieves distress for patients. 10,13 Patients who receive information about nutrition, exercise, fatigue, emotions, and/or work from a PN report that the information received is valuable and that PNs are perceived as accessible, reliable, and knowledgeable.…”

mentioning

confidence: 99%

“…Patient navigation, as a tool in health care delivery, has demonstrated efficacy in aiding medically underserved populations,11 serving as a valuable service for both patients and medical staff. Research studies indicate through PN, patients have a reliable resource that focuses on their needs, and medical staff have professionals who coordinate appointments and educate patients about treatments 12. PNs act as a liaison between the cancer patient and medical professionals, which improves patient-provider communication and relieves distress for patients 10,13.…”

mentioning

confidence: 99%

Enhancing Cancer Care Coordination Among Rural Residents

Rivers

Rivers²

2022

Medical Care

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W ithstanding landmark legislation such as the Affordable Care Act and cutting-edge scientific advances in cancer diagnosis and treatment, rural residents in the United States continue to experience more frequent and higher severity of multilevel barriers to quality cancer treatment services including lack of access to guideline-concordant treatment. 1 The rural health care landscape in the United States continues to be plagued by financial distress, health care professional shortages, hospital closures, geographic isolation, and high chronic disease burden. 2 These issues persist despite a substantial increase in the number of hospitals designated as a Critical Access Hospital (CAH). In 1997, Congress created the CAH designation to reduce the financial vulnerability of rural hospitals and improve access to health care by retaining essential services in rural communities. 3 CAH must meet the following requirements to obtain CAH designation: (1) have 25 or fewer acute care inpatient beds; (2) be located > 35 miles from another hospital; (3) maintain an annual average length of stay of 96 hours or less for acute care patients; and (4) provide 24/7 emergency care services. 3 Despite increased numbers of CAHs, access to cancer care continues to be a challenge for rural areas, as suggested by the high cancer mortality rates in comparison to urban areas. [4][5][6] Patient, provider, and institutional level factors have been well documented as contributors to these disparate cancer outcomes. 7 Rural counties have some of the highest rates of poverty, where residents are faced with limited availability to cancer treatment and supportive care services, transportation barriers, and financial issues. [4][5][6][7] Importantly, while 20% of Americans reside in rural areas, only 10% of physicians practice there, and those delivering cancer care have limited access to comprehensive care service delivery models. 7 The challenge at the institutional level for CAH is multifactorial-lack of skilled health care workforce, financial constraints, patient volume, and space. Compositely, these challenges drive cancer health disparities and impede the advancement of health equity.In this issue of Medical Care, Hung et al 8 examined the availability of cancer treatment services across CAHs and Prospective Payment System (PPS) hospitals. Through the conduct of a retrospective, time-series analysis using data from 2008 to 2017 American Hospital Association Annual Surveys and multivariable logistic regression, the authors examined current cancer services changes over time and relevant differences between urban and rural hospitals under the PPS and CAHs. The independent variable was hospital type (urban PPS, rural PPS, and CAHs), and the dependent variable was the presence or absence of 2 therapeutic services (chemotherapy and radiation therapy). The results of the analyses revealed rural PPS hospitals and CAHs had lower rates of comprehensive oncology, chemotherapy, and radiation therapy availability over time. Although the differences in ch...

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Overcoming geographical and socioeconomic limitations in colorectal cancer screening

Rozani,

Lykoudis

2024

World J Gastrointest Oncol

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Despite colorectal cancer’s (CRC) high global incidence, residents of low- and middle- income countries, as well as low-income minorities in advanced economies have low screening rates. Observational studies demonstrate that in these groups higher incidence of CRC is observed, yet screening rates remain low for consistent reasons. Low income, low educational background, and lack of awareness in combination with inadequate social security of certain population groups impede access and compliance rates to CRC screening. On the other hand, despite the global availability of multiple screening approaches (colonoscopy, sigmoidoscopy, faecal occult blood test, faecal immunochemical test, computed tomography-colonography, etc. ) with proven diagnostic validity, many low-income countries still lack established screening programs. The absence of screening guidelines in these countries along with the heterogeneity of guidelines in the rest of the world, demonstrate the need for global measures to tackle this issue comprehensively. An essential step forward is to develop a global approach that will link specific elements of screening with the incidence and available resources in each country, to ensure the achievement of at least a minimum screening program in low-income countries. Utilizing cheaper, cost-effective techniques, which can be carried out by less specialized healthcare providers, might not be equivalent to endoscopy for CRC screening but seems more realistic for areas with fewer resources. Awareness has been highlighted as the most pivotal element for the effective implementation of any screening program concerning CRC. Moreover, multiple studies have demonstrated that outreach strategies and community-based educational programs are associated with encouraging outcomes, yet a centrally coordinated expansion of these programs could provide more consistent results. Additionally, patient navigator programs, wherever implemented, have increased CRC screening and improved follow-up. Therefore, global coordination and patient education seem to be the main areas on which policy making needs to focus.

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Benefits, Cost, and Activities of Patient Navigation (PN) Program for Colorectal Cancer Screening at the Charles B. Wang Community Health Center (CBWCHC)

Cited by 3 publications

References 24 publications

Derivation of a Unique, Algorithm-Based Approach to Cancer Patient Navigator Workload Management

Derivation of a Unique, Algorithm-Based Approach to Cancer Patient Navigator Workload Management

Enhancing Cancer Care Coordination Among Rural Residents

Overcoming geographical and socioeconomic limitations in colorectal cancer screening

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