Development of a workflow process mapping protocol to inform the implementation of regional patient navigation programs in breast oncology. (14th June 2022)

• Record Type: Journal Article
• Authors: Casanova, Nicole L.; LeClair, Amy M.; Xiao, Victoria; Mullikin, Katelyn R.; Lemon, Stephenie C.; Freund, Karen M.; Haas, Jennifer S.; Freedman, Rachel A.; Battaglia, Tracy A.
• Other Names: James Ted A. investigator.; McCauley Susan investigator.; Ohrenberger Ellen investigator.; Ross JoEllen investigator.; Magrini Leo investigator.; Gershman Susan T. investigator.; Kennedy Mark investigator.; Levine Anne investigator.; Warner Erica T. investigator.; Clark Cheryl R. investigator.; Adams William G. investigator.; Bak Sharon investigator.; Battaglia Tracy A. investigator.; Casanova Nicole investigator.; Debrito Janice investigator.; Finn Katie investigator.; Gunn Christine investigator.; Hernandez Jackeline investigator.; Ko Naomi Y. investigator.; Maschke Ariel investigator.; Mullikin Katelyn investigator.; Ochoa Laura investigator.; Robbins Charlotte investigator.; Shanahan Christopher W. investigator.; Steil Samantha investigator.; Xiao Victoria investigator.; Cabral Howard J. investigator.; Chen Clara investigator.; Finney Carolyn investigator.; Lloyd‐Travaglini Christine investigator.; Loo Stephanie investigator.; Contreras Magnolia investigator.; Freedman Rachel A. investigator.; Raymond Yoscairy investigator.; Toffler Deborah investigator.; Burns White Karen investigator.; Murphy Anne Marie investigator.; Benjamin Carmen investigator.; Moy Beverly investigator.; Haas Jennifer S. investigator.; Marotta Caylin investigator.; Navarrete Aileen investigator.; Oravcova‐Mejia Mira investigator.; Percac‐Lima Sanja investigator.; Whited Emma investigator.; Wint Amy J. investigator.; Freund Karen M. investigator.; Harvey William F. investigator.; Krzyszczyk Danielle investigator.; LeClair Amy M. investigator.; Parsons Susan K. investigator.; Tsering Dolma investigator.; Wang Feng Qing investigator.; Rajabiun Serena investigator.; Lemon Stephenie C. investigator.;
• Is Part Of: Cancer. Volume 128:Supplement S13(2022)
• Page Start: 2649
• Page End: 2658
• Publication Date: 2022-06-14
• Subjects: breast cancer -- health equity -- implementation science -- patient navigation -- quality improvement; Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.33944
• Languages: English
• ISSNs: 0008-543X

Abstract

Abstract : BACKGROUND: Implementing city‐wide patient navigation processes that support patients across the continuum of cancer care is impeded by a lack of standardized tools to integrate workflows and reduce gaps in care. The authors present an actionable workflow process mapping protocol for navigation process planning and improvement based on methods developed for the Translating Research Into Practice study. METHODS: Key stakeholders at each study site were identified through existing community partnerships, and data on each site's navigation processes were collected using mixed methods through a series of team meetings. The authors used Health Quality Ontario's Quality Improvement Guide, service design principles, and key stakeholder input to map the collected data onto a template structured according to the case‐management model. RESULTS: Data collection and process mapping exercises resulted in a 10‐step protocol that includes: 1) workflow mapping procedures to guide data collection on the series of activities performed by health care personnel that comprise a patient's navigation experience, 2) a site survey to assess program characteristics, 3) a semistructured interview guide to assess care coordination workflows, 4) a site‐level swim lane workflow process mapping template, and 5) a regional high‐level process mapping template to aggregate data from multiple site‐level process maps. CONCLUSIONS: This iterative, participatory approach to data collection and process mapping can be used by improvement teams to streamline care coordination, ultimately improving the design and delivery of an evidence‐based navigation model that spans multiple treatment modalities and multiple health systems in a metropolitan area. This protocol is presented as an actionable toolkit so the work may be replicated to support other quality‐improvement initiatives and efforts to design truly patient‐centered breast cancer treatment experiences. LAY SUMMARY: Evidence‐based patient navigation in breast cancer care requires the integration of services through each phase of cancer treatment. The Translating Research Into Practice study aims to implement patient navigation for patients with breast cancer who are at risk for delays and are seeking care across 6 health systems in Boston, Massachusetts. The authors designed a 10‐step protocol outlining procedures and tools that support a systematic assessment for health systems that want to implement breast cancer patient navigation services for patients who are at risk for treatment delays. Abstract : A workflow mapping protocol is designed to support health systems plan for the implementation of a breast cancer patient navigation program to support patients across multiple treatment modalities. This tool may be used to disseminate evidence‐based navigation in oncology care.