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Scheduling Diagnostic Mammograms

November 19, 2019 | What Would Lillie Do?

Name: Brenda
Position: Nurse Navigator
Subject: Patients scheduling their own diagnostic mammogram

Question:
As an oncology navigator at a breast center, part of my job is to call patients to schedule their diagnostic mammogram. Of course, there are always patients who may receive their result letter in the mail prior to talking with me. Those patients have always been able to call scheduling or myself and make that diagnostic appointment. (Once she is scheduled, the schedulers would alert me and I would contact her physician for a diagnostic order.) Recently, this process is being challenged by scheduling as well as radiology supervisors—some even citing that allowing the patient to do this is illegal! It seems that if we are legally required to send the patient her results, which includes the recommendation for follow-up, that she should be able to call and schedule that appointment. Any assistance you can give me in advocating for my patients would be greatly appreciated.

Answer:
Diagnostic imaging requires a doctor’s (or NP’s) written order; therefore, that is likely the issue. Perhaps it has been done ahead of the order, then in retrospect, the order is written is my guess. Also, the type of diagnostic imaging needed requires the opinion of the doctor—does the patient need spot films or an ultrasound, or even a breast MRI? It isn’t as straightforward as it seems.


Name: Cheryl
Position: Nurse Navigator
Subject: Navigation patient tracking

Question:
Hi Lillie,

Are there any forms or templates for oncology navigators to quickly document their daily patient “touches” so to speak and the reason without adding more work to the day?

Also, is there another way navigators can participate in the testing process for certification without the expense of attending a conference? The cost is prohibitive for some of us. I should mention that I have attended a conference in the past, but was not eligible at the time to take the exam.

Answer:
Some people use an Excel spreadsheet. Ideally, however, navigators should have their own section in the electronic patient record (in EPIC, for example). It is very important to have documentation as part of the official medical record as well as a way to share that information with the multidisciplinary team as needed. Documenting what you did, why, and how long it took (meaning the length of time it took you to carry out a conversation or perform a specific task, such as arranging for transportation for the patient to get their radiation treatments) should all be tracked.

You are not required to attend the conference to sit for the AONN+ Certification Exam.

For more information, please our Certification FAQ.

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