Navigation in oncology in an adult emergency department of a private general hospital: experience report

Keywords

navigation - oncology - oncological emergencies - emergency department

Introduction: The emergency department (ED) of a general hospital presents challenges in providing care to cancer patients. Navigation is a process that can contribute to expediting care, offering patient-centered care, and reducing healthcare costs.

Objective: To describe the experience of implementing an oncology navigation process in the adult ED of a private general hospital.

Methods: This is an experience report on the implementation of a multi-stage navigation project. In this summary, the focus is on demonstrating indicators related to the time of care during the patient's journey in the ED. The project was implemented in a private general hospital. The team responsible for developing the project identified the cancer patient journey in the ED and selected indicators (total number of visits in the ED and cancer patients; triage time; time to medical care; time to outcome). A nurse who worked in the sector, after intensive training related to oncology navigation, had the following responsibilities: to identify cancer patients who came to the department, coordinate patient care in light of the nursing process, and serve as an interface between the ED and Oncology care teams. The indicators were collected from records in the electronic medical record.

Results: We will present the indicators comparing the average between March 2022 and February 2023 (referred to as the pre-project period) and March 2023 (the month of project implementation) through February 2024 (referred to as the implementation period). The average monthly visits during the pre-project period were 10,583 and 11,090 during the implementation period. The average monthly visits of cancer patients were 106.25 during the pre-project period and 238 during the implementation period. The average triage time was 00h06min during the pre-project period and 00h09min during the implementation period. The average time to medical care was 00h43min during the pre-project period and 00h37min during the implementation period. The time to outcome was 11h39min during the pre-project period and 04h12min during the implementation period.

Conclusion: With the implementation of the navigation nurse in the emergency department, it was possible to observe a reduction in the time to medical care and time to outcome. Implications for practice: The navigation nurse plays a fundamental role in all care scenarios for cancer patients. In a general emergency department, they can contribute to improving care for patient

Corresponding author: Danielle Thaise Ambrosio (e-mail: [e-mail]).