“I want to be aware of the navigator and support services as soon as possible.”
This is a frequent response from patients when asked about the optimum point in the cancer care journey to learn about navigation and support services.
And yet, during a first visit (or intake interview) with a patient, navigators may question how much to review. Where is the balance between too much information and not enough? Based on my experience in care coordination and patient navigation, here’s my perspective on creating and using an intake assessment tool.
Number 1 Rule: Assess if the patient is ready for this discussion. First, provide support. Let the patient and his or her family take the lead in the conversation. Listen. Then, based on your assessment, ask the patient and family if they are ready to review the support services and their specific needs. Once you receive their permission, you can then initiate the intake assessment process.
Each cancer program should have a consistent process for assessing and educating patients and families about the cancer program and support services. A well-crafted intake assessment tool can be used for all cancer disease sites and should include the following:
- Role of the navigator and the support staff at your cancer center
- Mini assessment of immediate support service needs
- Preferred learning style for education
- Questions that prompt a conversation on what the patient knows about his or her cancer
- Questions to elicit from the patient―specific concerns, goals, and family concerns
- Family, medical, and surgical history
- Mini symptom and behavior risk assessment
- List of national and community resources (usually included in patient’s treatment journal).
Gathering this essential information at the time of your initial visit with the patient will establish a strong foundation for the multidisciplinary team. The navigator’s assessment process is an opportunity to begin the discussion about goals of care and/or goals of their treatment—a pillar for providing patient- and family-centered care. Furthermore, identifying patients’ preferred learning style and using it across the continuum sets them up to succeed in understanding their cancer and treatment plan. This information can be shared at tumor conferences, multidisciplinary meetings, huddles, or via e-mail if a secure environment is established. It is also vital to support the navigator role in educating the patient and family consistently, as well as providing an important resource tool for navigators who may be called on to cover for a colleague. An assessment tool is a key component for a consistent foundation to navigation, but health literacy training and patient education teach-back methods can enhance the process and support staff success in educating patients and their families.
Assessing the immediate needs of the patient and family, while providing education and support, establishes a patient-centered approach and lays the groundwork for a strong bond between the patient, family, navigator, and the support services.
View a sample navigation intake assessment tool. You are welcome to revise this tool as needed for your cancer program.
ACCC member Tricia Strusowski, MS, RN, is a consultant with Oncology Solutions, LLC.