A new figure in oncology pathways: Oncology Nurse Navigator and his preliminary results in the San Benedetto del Tronto Surgery

Abstract

Background. The role of the Nurse Navigator was developed in order to address the health disparities created by the social determinants of health, , being an expert, specialized and trained nurse who takes charge of the patient diagnosed with cancer and accompanies him throughout the treatment process, helping him to extricate himself from the labyrinth of the healthcare system. This figure was introduced and studied in the general surgery of the Madonna del Soccorso hospital in San Benedetto del Tronto. Objective. Primary outcomes are the reduction of time interval between the first patient contact and each phase of the diagnostic and therapeutic pathway. Secondary outcomes are the assessment of the number and frequency of contacts between the patient and the ONN, as well as of the number and type of organized procedures, and patient satisfaction assessment. Methods. A prospective cohort study was conducted with a historical control group represented by the same number of cancer patients treated in the same surgical unit in the previous year and not followed by an ONN. The patients’ contacts were registered within a dedicated mobile number. A questionnaire on patient satisfaction with cancer care was completed and administered to patients in a blinded manner by a third party to avoid bias. Results. The study group included 30 cancer patients. The average time from first contact to primary diagnostic test was 8 days versus 20 days in 2022 (control group). All patients underwent discussion by a multidisciplinary team (MDT), and the time to reach the MDT discussion was not different between the 2 groups. Five patients were deemed ineligible for surgery, and the average time to referral to a medical oncologist was 2 days in the study compared to 10 days in the control group. Twenty-five patients were eligible for initial surgery, and the mean time from first contact to surgery was 23 days after ONN establishment compared with 45 days in the control group. Each patient had an average of 10 phone calls with the ONN. For patients with a first diagnosis of cancer, the ONN organized an average of 4 tests. A patient satisfaction questionnaire achieved a response rate of 100%, with an average score of 85.2/90. Conclusion. The data demonstrate that ONN service is effective and may improve the quality and outcomes of the management path of surgical oncology patients. The professional role of the ONN, with predefined technical and non-technical skills, should also be officially recognized by the healthcare system and hospital administration.