The Value of the Virtual Care Connection: Oncology Tele-Navigation
Michele Gaguski, RN, Christine Miller, RN, Susan Saporito, RN
Like the rest of the country, the Sidney Kimmel Cancer Center at Jefferson Health New Jersey was up to the challenge of providing care for our patients during the COVID-19 pandemic. Oncology nurse navigators collaborated with the entire cancer center team to be frontline screeners for the cancer center and perform a quick COVID-19 assessment, take temperatures, and guide patients to a safe visit. While screening a patient, I overheard the name of one of my navigated patients that I supported frequently. I introduced myself as her nurse navigator and our eyes smiled at each other above our masks as we air-hugged. This was the new normal during this pandemic. Even though our face-to-face meeting was now through a mask and shield, it provided a glimpse of the human touch.
Throughout the pandemic, nursing leadership met with the nurse navigators to learn more about the usefulness and versatility of telehealth for patients with cancer and the utility of this technology within the navigation department. The nurse navigator team was continuing to reach patients via phone to provide support, education, and guidance. Thinking this through with nursing leadership and the breast center team, the idea of using telehealth for nurse navigation was explored. Telehealth was being used successfully for medical and nurse practitioner provider visits in all the departments. It became clear that it was time to bring this technology to nurse navigation. This was a team effort with the breast center team, nursing leadership, telehealth support team, and the informatics technology (IT) team. A schedule was created with our Epic EMR system for the nurse navigator team at our cancer center and allowed a face-to-face connection for patients with their nurse navigators. The nurse navigators enrolled and attended telehealth training. It quickly became apparent that the time and energy invested in telehealth was more than worthwhile. To start, the navigators are piloting and collecting data with the use of telehealth in patients with breast cancer. Nurse navigation now calls the patient prior to their breast surgical consultation as an introduction and schedules a telehealth visit following that appointment for further follow-up. Oncology nurse navigators can once again “meet” with patients and deliver nursing care virtually throughout the cancer care continuum.
We completed our first telehealth visit with a patient with newly diagnosed breast cancer. The telehealth visit lasted for 25 minutes, during which we reviewed her plan of care. I was able to assess the patient’s level of anxiety by the look on her face when she said, “I want to be told the truth about my condition even if it’s not good news.” This was an important need for her, and I also assessed the level of understanding and engagement with our discussion by her facial expressions and the fact she was writing down several points of information as we spoke. Being able to see her face-to-face not only helped with my assessment, but it also provided a personal touch that enabled and improved patient experience during this time. Data is being collected on tele-navigation volumes, the number of barriers identified, and the number of visits completed successfully without having to revert to the phone. With the use of this data, the team will continue to improve our tele-navigation program while delivering an exceptional patient experience during these unprecedented times.