Team-Based Oncology Care
Because cancer is such a complex disease, the patient encounters myriad medical professionals and ancillary support service over the many months or years they are receiving treatment and survivorship/end-of-life care. Each person has designated roles and responsibilities, from the pathologist and radiologist determining the extent of the disease, to the oncology specialists determining the optimal treatment and care, to the woman who works at the wig salon and fits the cancer patient with a wig in preparation for hair loss caused by cancer treatments.
While a patient is going through phases of care, across the cancer continuum, various oncology team members will enter and exit the patient’s life. Coordinating this case, identifying and removing barriers to care, and providing a consistent touch point are needed so that the patient can feel a sense of connection to the team overall, as well as have a professional who is a constant as they go along this daunting journey. A professional that provides this consistent contact and communication in most cases is a navigator—whether it be a nurse navigator or a lay patient navigator.
This chapter briefly summarizes recommendations from selected Institute of Medicine (IOM) reports and roundtables and the American College of Surgeons Commission on Cancer. Challenges to quality care and how maintaining quality may be impacted by the growing shortage of the oncology workforce is happening simultaneously to the growing volume of newly diagnosed cancer patients. Similarly, cancer care is fragmented requiring cancer patients to receive care from multiple facilities as well as within diverse departments and centers of the cancer center. Patient navigators, whether nurse navigators or lay patient navigators, or both working together, strive to provide continuity in the midst of such fragmentation and collaboration so that care can be delivered in a more seamless way. If a patient drops through the cracks and doesn’t get all of the treatment needed and in keeping with NCCN treatment guidelines, they increase their risk of recurrence or even mortality. If there are wide gaps in treatment, this, too, can place the patient at higher risk. These navigators are key, serving as the patient advocate and promoting the concept of patient-centered care, including identification and dovetailing of the patient’s life goals into the treatment planning process so that the patient remains on track for their preestablished life goals. Additionally, they can promote the development of additional life goals that are new, which can be added to the patient’s survivorship care plan, focusing on living and enjoying their life as a cancer survivor.
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