Breast Cancer Clinical Trial
Official title:
Pilot Project to Better Understand Non-Clinical Needs of Cancer Patients
The Stanford Cancer Center is undertaking a Transformation Initiative in order to improve the quality of care and care coordination across the continuum of care. The newest innovation is to introduce lay navigators to specified high-need patients. The larger goal of the project is to assess whether lay navigators can address non-clinical patient needs in a timely fashion and appropriately connect them with their clinical team when warranted. It is expected that proactive interaction with patients will decrease patient anxiety/stress related to their cancer and facilitate higher patient engagement and improved management of physical, social,and emotional health. For the pilot project, the smaller goal is to understand: how lay navigator time is used; the types and frequency of issues brought up by patients; resources that patients are given or referred to; type and frequency of mode of contact with patients; and patients' acceptance of navigators based on refusal. An electronic intake form will be used to collect this information so that data can be analyzed regularly to inform changes to the navigator program as needed.
The Stanford Cancer Institute is undergoing a 5-year Transformation Initiative that began in
2013. One of the goals of this initiative is to increase patient engagement. The underlying
premise is that engaged patients will be more likely to attend all their visits, receive all
their treatments, and understand ways to manage treatment side effects so that they are less
likely to go to the emergency room (ER) or be admitted to the hospital. An approach being
tested is to use lay navigators to help identify patient issues and help them address the
issues through a combination of direct supportive activities (e.g., calling clinical team for
the patient) and activities that help the patients help themselves (helping them understand
when side effects warrant a call to their clinical team that they make themselves).
Information including patient acceptance/refusal of navigator services; number and types of
contacts with patients (phone, in-person, email); types of issues discussed (financial,
social, educational, physical, emotional, etc); referrals made; and time spent with patients
for each encounter will be routinely entered by the navigators for each patient contact. The
data entered will be evaluated regularly to closely monitor navigator activities and better
understand cancer patient issues/needs. This information will be used to inform possible
training needs of navigators, educational needs of patients,needs for better referral
support,help predict navigator case-load, and other issues.
Eligibility Criteria:
All new biopsy positive cancer patients that have a treatment plan to receive at least 2
treatment modalities: surgery, chemotherapy and/or radiation therapy at Stanford are
eligible. Because there will be more patients eligible than the navigators can manage, only
patients with an even MRN will receive a navigator for the pilot. The overall purpose of the
pilot is to learn which patients benefit most and which services navigators are able to best
help with. The investigators expect the pilot to last 6-12 months. Mixed methods will be used
to evaluate the navigators and will include existing patient experience surveys, unscheduled
hospitalizations, ER visits, interviews with patients, staff (including navigators), and
physicians regarding their experience with and perceived value of navigators.
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