Being accredited by the Commission on Cancer (CoC) provides a distinction that the cancer program uses a multidisciplinary approach dedicated to providing high quality cancer care. Oncology navigation plays a valuable role in the multidisciplinary team that supports that accreditation. A major focus of the navigator role is assisting patients to overcome barriers to care that prevent them from adhering to the recommended treatment plan. ONCONav supports documentation and reporting of this information, as well as others that demonstrate the cancer program’s compliance to CoC standards. The CoC standards supported by ONCONav will be described briefly, followed by how ONCONav supports documentation and reporting of those standards.
CoC Standard 4.4 Genetic Counseling and Risk Assessment
Compliance measures for CoC Standard 4.4 Genetic Counseling and Risk Assessment begin with the cancer program selecting a site-specific cancer that will be a focus. The cancer program will be evaluated to ensure that patients with that cancer type who meet qualifications for genetic counseling are identified and referred to genetic services. These services should be with an educated genetics professional who has specialized training in oncology genetics and hereditary cancers. The cancer program should have policies, procedures, and processes in place for genetic counseling and risk assessment that is consistent with evidence-based national guidelines.
ONCONav supports documentation, tracking, and reporting of genetic counseling and risk assessment by oncology navigators who may assist in identifying the patient for genetics, as well as the genetic counselor performing those services. Information about the patient’s risk factors, referrals, potential syndromes to consider, education provided, plans for testing, and the test results can be documented and reported. Follow up is easily managed with ONCONav to ensure that patients and providers are informed of the results in a timely manner.
Standard Compliance
Compliance with this standard can be demonstrated using reporting from data documented in ONCONav. This data can be broken down by navigator, disease type, and other variables. The information returned can be valuable in determining areas that may need process improvement. This includes, but is not limited to, the following report examples:
- The number patients referred for genetic counseling
- The number of those referrals that received testing
- Turnaround time from referral to the genetic counseling visit
CoC Standard 4.5 Palliative Care Services
CoC Standard 4.5 Palliative Care Services notes that palliative care services should be available to cancer patients and their families by members of the oncology team including doctors, advanced practitioners, nurses, social workers, mental health professionals, and spiritual counselors. Palliative care services can include care planning with the patient, family, and healthcare team; symptom management; spiritual and psychosocial support for patients and families; and bereavement support for families and members of the healthcare team. The cancer program should have policies and procedures for palliative care services, including the criteria for referring to palliative care.
Oncology navigators are patient advocates and may play a vital role in deciding when a patient should consider palliative care. ONCONav supports this process with an evidence-based palliative care evaluation that helps the navigator determine if it may be time to discuss palliative care with the doctor.
Each cancer program can implement their own process using the patient’s score to determine when patients should be referred for palliative care services.
Standard Compliance
Compliance with this standard can be demonstrated using reporting from data documented in ONCONav. This data can be broken down by navigator, disease type, and other variables. The information returned can be valuable in determining areas that may need process improvement. This includes, but is not limited to, the following report examples:
- The number of palliative care evaluations completed
- The number of patients referred to palliative care
- Turnaround time from referral to palliative care visit
CoC Standard 4.8 Survivorship Program
The focus of CoC Standard 4.8 Survivorship Program is implementing a survivorship program with a multidisciplinary team that offers numerous services to support cancer patients in survivorship. A minimum of three survivorship services should be documented each year and can include survivorship care plans, treatment summaries, screening programs for recurrence or new cancers, rehab or nutritional services geared toward the cancer survivor, support groups, and a host of others.
ONCONav assists navigation programs with tracking and managing their survivorship program services. The Survivorship Issues barrier allows documentation and tracking of any of the services referenced in the standard as interventions for that patient including providing the survivorship care plan. Survivorship care plans can populate with data documented in ONCONav or your cancer registry and include follow up care based on ASCO guidelines.
Standard Compliance
Compliance with this standard can be demonstrated using reporting from data documented in ONCONav. This data can be broken down by navigator, disease type, and other variables. The information returned can be valuable in determining areas that may need process improvement. This includes, but is not limited to, the following report examples:
- The number of patients in survivorship that were referred to survivorship services
- The number of each service provided
CoC Standard 5.2 Psychosocial Distress Screening
CoC Standard 5.2 Psychosocial Distress Screening indicates that the cancer program should have policies and procedures in place to assess and address psychosocial distress. This includes screening cancer patients for distress at least once during the first course of treatment, meaning the time frame between diagnosis and progression or recurrence, using an evidence-based tool. If the patient has evidence of moderate or severe distress, they must be further assessed by a member of the oncology team to include the doctor, nurse, social worker, or mental health professional.
ONCONav utilizes a tool based on the most current version of the NCCN Distress Thermometer. It allows navigators to document directly in the system and to add barriers, interventions, and referrals from within the evaluation to better streamline the navigator’s workflow. ONCONav can also be customized to include other distress evaluations that you may use such as the Patient Health Questionnaire, or PHQ, to support compliance with this standard.
Standard Compliance
Compliance with this standard can be demonstrated using reporting from data documented in ONCONav. This data can be broken down by navigator, disease type, and other variables. The information returned can be valuable in determining areas that may need process improvement. This includes, but is not limited to, the following report examples:
- The number of patients with distress screening completed
- The number of patients referred to resources or for follow up
- The number of each resource referred
- Distress screening scores per disease type and other variables
CoC Standard 8.1 Addressing Barriers to Care
CoC Standard 8.1 Addressing Barriers to Care is largely managed by navigation. The cancer program will identify at least one barrier to health or psychosocial care for the oncology patients in your community. This barrier may be patient-based such as lack of transportation, system-based as with delays in patients being admitted for inpatient chemotherapy due to pre-admission processes, or provider-based like delays in appointments due to physician scheduling.
ONCONav provides the ability to track and document barriers to care for the cancer patient, as well as all the interventions provided to address these barriers. Both the barriers and the interventions can be customized to those resources you use at your facility or within your community. The success of individual interventions can be tracked as well which may help to identify the barrier monitored for this standard.
Standard Compliance
Compliance with this standard can be demonstrated using reporting from data documented in ONCONav. This includes, but is not limited to, the following report examples:
- The number of barriers and their associated interventions documented
- Most and least encountered barriers; Most and least provided interventions
- Most and least successful interventions, resources, and referrals
Commission on Cancer accreditation is just one of the many ways that ONCONav helps to support navigation programs. Generating the pre-built reports in Reports Plus or creating a custom report with Ad Hoc allows navigation programs to track metrics that further support return on investment for the navigators and show benefit to the cancer program. For more information about CoC support or general reporting in ONCONav, please reach out to us at support@onco-nav.com. If you’re not a current client and would like to see a demo, please email us at sales@oncolog.com or click the link Schedule a Demo from the Onco website.
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