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Sylvester Oncology On-Demand (SOON) and Nurse Navigators at the Helm

New Knowledge, Innovations, and Improvements

Sylvester Comprehensive Cancer Center, a National Cancer Institute (NCI) designated comprehensive cancer center leads in nursing efforts to achieve optimal patient outcomes across the cancer trajectory. Among the pioneering nursing leadership efforts are the Sylvester Oncology On Demand (SOON) program and the Early Symptom Management in the Outpatient Setting program. Leadership for the SOON program includes a team of nursing and professional staff including Jessica MacIntyre, MSN, APRN, NP-C, AOCNP, Executive Director, Clinical Operations; and Sophie Torrents, MHA. Through their efforts in implementing a nurse navigation on-demand telehealth program, which offers services to over 20,000 new patients each year across the one main campus and eight satellite locations. With input from the SCCC Patient and Family Advisory Council, the on-demand nursing program was developed to improve retention rates and offer optimal approaches to serve their catchment area. The implementation improved the experience of patients by offering scheduled video or phone appointments with a nurse navigator within 24 hours of patients seeking an initial appointment. Date indicated that 100% of patients valued being able to schedule an appointment with a nurse navigator. Roles of the nurse navigator—a program that is viewed as an optimal approach to patient care by the Oncology Nursing Society—include coordination of appointments, offering learning and educational resources; financial and insurance assistance, and caregiver support. Notably, nurse navigator job satisfaction was reported as high with the initiation of the SOON program. [Insert photo of Carem Costa BSN, BS, RN and live video link with comments from Jessica MacIntyre, Sophie Torrents and Carem Costa].

The Early Symptom Management in the Outpatient Setting Program, led by advanced practice nurses, nursing staff, and interprofessional staff is another key program that impacts the quality of life of SCCC patients. Michelle Penaranda, MSN, APRN, AOCNP; Maritza Alencar, DNP, MBA, APRN-BC; Claudia Whitwell, MBA, LSSGB; Sophie Torrents, MHA, LSSBG; Jessica MacIntyre, MSN, APRN, NP-C, AOCNP; and Lauren Gjolaj, MBA, BSN, RN. Guided by the UHealth Nursing Professional Practice Model, the program was aimed at standardizing approaches to address early symptom management for patients receiving chemotherapy in the outpatient infusion setting. For optimal patient care, a consistent process was needed across all outpatient infusion sites. A follow-up phone call process was developed with advanced practice providers (APPs) who supported patients for early symptom management, addressing side effects, and advising about psychosocial concerns. The intervention included the development and launch of a dashboard that included a script created by the APPs to use during their phone calls with patients that ensured that all possible symptoms and potential issues that patients might encounter were addressed and patient tracking could be included in documentation. A post-call dashboard was developed in the electronic medical record system, EPIC to allow for the ease of reporting and tracking. As noted by MacIntyre: “The dashboard was linked to the master infusion schedule and logic was built to automatically identify patients that needed a call post-treatment. The use of the dashboard assisted in tracking compliance among the infusion center locations to assure optimal patient care.” A quality improvement approach was utilized with a patient survey to further understand the benefits of the program and opportunities to improve the patient experience and also to offer organizational benefits for SCCC—an exemplar of a nursing success story for SCCC.

[Insert photo of Penaranda, Alencar, Whitwell, Torrents, MacIntyre, and Gjola].