Page 21 - 2017 Nursing Annual Report | Summa Health

Nurse navigators lead efforts
to improve coordination
and collaboration of breast
cancer treatment

The healthcare industry is experiencing a growing crisis surrounding breast cancer care
delivery. Providers are encountering challenges in defining standardized “best” practice
and coordinating that care among many specialties, while cancer survivors and support
persons are struggling to understand multiple recommendations, keep numerous
appointments and incur the increased burden of various co-pays.

In an effort to alleviate these issues and improve the In fact, the Summa nurse navigator starts each breast
level of patient care, Summa Health launched our MDC process by conducting a custom, comprehensive
multidisciplinary clinic (MDC) for patients diagnosed intake assessment before the patient and support
with breast cancer in October 2017 (Figure 1). Focused persons even enter the clinic. This detailed evaluation
on improved access, treatment coordination and includes behavioral screenings, as well as discussions
collaboration between multidisciplinary specialty on medical and social history and supportive service
providers, the Summa Breast MDC provides patients and needs questions. It also involves baseline screenings
support persons with: for pain, fatigue, distress, arm measure and range of
motion (ROM), Patient Health Questionnaire (PHQ-9)
• Integrative interdisciplinary breast care in an for depression severity, and the Generalized Anxiety
individualized same-day consult Disorder Scale (GAD-7) to help gauge side effects
and post-surgical changes. Summa aligns with the
• Expedited access to specialty providers and support prehabilitative care model to prevent cancer side effects,
services rather than treating them after they occur.

• The opportunity to have their case reviewed by the The data gathered through the nurse navigator’s
multidisciplinary team assessment aids the Summa Breast MDC in anticipating
patient needs. It allows treatment planning by the entire
• Treatment recommendations utilizing evidenced- care team to start immediately before the patient’s MDC
based nationally recognized treatment guidelines that appointment and continue, with patient input, throughout
promote a multidisciplinary organized approach to the patient’s two-hour MDC visit. While the process
providing breast care may vary per individual, the MDC visit typically involves
a variety of nurse navigators, from imaging and breast
This highly collaborative approach may include oncology to high-risk and survivorship.
representatives from surgical oncology, medical
oncology, radiation oncology and psychology, as well During the final appointment of the day, the nurse
as medical residents, physical therapists, social workers, navigator reviews all of the clinic’s recommendations
financial counselors, dieticians, and even therapy animals. and establishes next steps with the patient. The nurse
But the first, and oftentimes last, point of patient contact navigator also provides an all-inclusive Summa Breast
with the Summa Breast MDC is the nurse navigator. MDC summary of the proposed care plan. “We empower
our patients to be active participants in the decision-
The nurse navigator role making process,” says Sharon Inzetta, RN, MS, CBCN,
CN-BN, ONN-CG. “While the MDC provides the best
Summa nurse navigators play a vital role throughout treatment options, it’s up to our patients to discuss them
the entire breast MDC continuum of care. From initial with their support persons and select the best plan for
diagnosis to treatment and survivorship, they remain in themselves.”
close communication with patients to ensure seamless
care coordination, efficient care delivery and removal of
care barriers.

2017 Nursing Annual Report 21