Measuring the Impact Navigation Has on Patient Care by Supporting the Multidisciplinary Team

  • Elaine Sein
  • Danelle Johnston
  • Tricia Strusowski
  • Cheryl Bellomo


As evidence guides practice, it is essential for navigation programs to identify core metrics and standardize data collection in order to clearly demonstrate program outcomes. There is discontinuity in the literature regarding the key areas that measure the success of navigation programs: patient experience (PE), clinical outcomes (CO), and business performance or return on investment (ROI) metrics. The National Quality Forum’s criteria for measure development designed a solid framework with four pillars: important to measure and report, scientifically acceptable, usable/relevant, and feasible to collect. The Academy of Oncology Nurse & Patient Navigators (AONN+) Metrics Task Force developed standard metrics using scientific methodology in the area of PE, CO, and ROI using the AONN+ domains for certification. These domains contain a comprehensive list of all areas navigators practice in order to provide quality patient care and financial stability for their organizations. The 35 developed metrics are baseline metrics that all navigation programs no matter what their structure should be evaluating and monitoring. Navigation programs are developing at different rates within diverse structural organizations and settings, which will determine which standardized metrics will be essential to measure outcomes for their specific navigation program. The metrics align with national standards such as the Commission on Cancer (CoC), National Accreditation Program for Breast Centers (NAPBC), Quality Oncology Practice Initiative (QOPI), and value-based care. National standards help drive continuous quality improvement, value, and identify best practice programs that elevate cancer care on a grander scale. The integration of performance improvement methodologies and data analytics drives quality outcomes and reimbursement.


  1. 1.
    Brown B, Falk LH. Embarking on performance improvement. Healthc Financ Manage. 2014;68:98–103.PubMedPubMedCentralGoogle Scholar
  2. 2.
    Strusowski P, Sein E, Johnston D, et al. Standardized evidence-based oncology navigation metrics for all models: a powerful tool in assessing the value and impact of navigation program. J Oncol Navig Surviv. 2017;8(5):220–37.Google Scholar
  3. 3.
    McGillicuddy P, Gold K, Lowe M. Developing core competencies for interprofessional teams: a script-reading approach. In: Christ G, Messner C, Behar L, editors. Handbook of oncology social work: psychosocial care for people with cancer. New York: Oxford University Press; 2015. p. 785–91.Google Scholar
  4. 4.
    Institute of Medicine. Delivering high-quality cancer care. Washington, DC: The National Academies Press; 2013.Google Scholar
  5. 5.
    Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: The National Academies Press; 2001.Google Scholar
  6. 6.
    National Learning Consortium. Shared decision making. 2013.
  7. 7.
    Loscalzo M, Clark K, Bultz BD. Integrated interdisciplinary staff leadership model of patient-centered care. In: Christ G, Messner C, Behar L, editors. Handbook of oncology social work. New York: Oxford University Press; 2015. p. 595–600.Google Scholar
  8. 8.
    Stevens KR. The impact of evidence-based practice in nursing and the next big ideas. Online J Issues Nurs. Accessed 31 May 2017.
  9. 9.
    National Quality Forum. ABCs of measurement. Accessed 4 May 2017.
  10. 10.
    National Cancer Institute. NCI dictionary of cancer terms: medical oncologist.
  11. 11.
    Standardized Metrics Source Document.
  12. 12.
    Centers for Medicare and Medicaid Services (CMS).
  13. 13.
    National Cancer Institute. Surgery. 2015.
  14. 14.
    Oncology Nursing Society Oncology Nurse Navigator Core Competencies. 2013.
  15. 15.
    National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology. (NCCN Guidelines). Distress Management Version 1.2014.
  16. 16.
  17. 17.
    Board of Pharmacy Specialists. Oncology pharmacy.
  18. 18.
    Bauer, A. Spotlight on: Oncology pharmacists—Part I, a Q&A. 2014.
  19. 19.
    National Consensus Project for Quality Palliative Care. Clinical practice guidelines for quality palliative care. 3rd ed. Author: Pittsburgh, PA; 2014.Google Scholar
  20. 20.
    Institute of Medicine. Crossing the quality chasm: a new health system for the 21st century. Washington, DC: National Academies Press; 2001.Google Scholar
  21. 21.
    Smart Goal Setting. 2010–2016.
  22. 22.
    Strusowski, T, Sein E, et al. Standardized metrics source document. 2017. Accessed 15 May 2017.
  23. 23.
    Strusowski T, Stabb J. Patient navigation metrics, measuring the impact of you patient navigation services., January–February 2016.CrossRefGoogle Scholar
  24. 24.
    Stewart MA, Rodriguez R. Patient navigation in oncology. In: Christ G, Messner C, Behar L, editors. Handbook of oncology social work. New York: Oxford University Press; 2015. p. 659–65.Google Scholar
  25. 25.
    Association of Community Cancer Centers. Communicating quality in oncology. 2014. .
  26. 26.
    Gilbert E, Sherry V, et al. Health care metrics in oncology. J Adv Pract Oncol. 2015;6(1):57–61.Google Scholar
  27. 27.
    Makari-Judson G, Wrenn T, Mertens WC, et al. Using quality oncology practice initiative metrics for physician incentive compensation. J Oncol Pract. 2014;10:58–62.CrossRefPubMedGoogle Scholar
  28. 28.
    Patel M, Patel K. The oncology care model: aligning financial incentives to improve outcomes. Oncol Pract Manage. 2016; 6. Accessed 15 Apr 2017.
  29. 29.
  30. 30.
    Porter ME. What is value in health care? N Engl J Med. 2010;363:2477–81. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Elaine Sein
    • 1
  • Danelle Johnston
    • 2
  • Tricia Strusowski
    • 3
  • Cheryl Bellomo
    • 4
  1. 1.Office of Community Outreach, Fox Chase Cancer Center PartnersPhiladelphiaUSA
  2. 2.Academy of Oncology Nurse & Patient Navigators, The Lynx GroupCranburyUSA
  3. 3.Oncology Solutions LLCDecaturUSA
  4. 4.Intermountain Cancer Centers, Cedar City HospitalCedar CityUSA

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