Department of Surgery, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
Department of Medicine, Wake Forest Baptist Medical Center, Winston Salem, NC, USA.
Ann Surg Oncol. 2019 May;26(5):1512-1518. doi: 10.1245/s10434-019-07157-6. Epub 2019 Jan 16.
Care of pancreatic cancer patients has become increasingly complex, which has led to delays in the initiation of therapy. Nurse navigators have been added to care teams, in part, to ameliorate this delay. This study investigated the difference in time from first oncology visit to first treatment date in patients with any pancreatic malignancy before and after the addition of an Oncology Navigator.
A single-institution database of patients with any pancreatic neoplasm evaluated by a provider in radiation, medical, or surgical oncology between 1 October 2015 and 30 September 2017 was analyzed. After 1 October 2016, an Oncology Navigator met patients at their initial visit and coordinated care throughout treatment. The cohort was divided into two groups: patients evaluated prior to the implementation of an Oncology Navigator and patients evaluated after implementation. Patient demographics and time from first visit to first intervention were compared.
Overall, 147 patients with a new diagnosis of pancreatic neoplasm were evaluated; 57 patients were seen prior to the start of the Oncology Navigator program and 79 were evaluated after the navigation program was implemented. On univariate analysis, time from first contact by any provider to intervention was 46 days prior to oncology navigation and 26 days after implementation of oncology navigation (p = 0.005). While controlling for other covariates, employment of the Oncology Navigator decreased the time from first contact by any provider to intervention by almost 16 days (p = 0.009).
Implementing an oncology navigation program significantly decreased time to treatment in patients with pancreatic malignancy.
胰腺癌患者的护理变得越来越复杂，这导致治疗开始的延迟。护士导航员已被添加到护理团队中，部分原因是为了缓解这种延迟。本研究调查了在添加肿瘤导航员前后，任何胰腺恶性肿瘤患者从首次肿瘤就诊到首次治疗日期的时间差异。
分析了 2015 年 10 月 1 日至 2017 年 9 月 30 日期间由放射、内科或外科肿瘤学医生评估的任何胰腺肿瘤患者的单机构数据库。2016 年 10 月 1 日之后，肿瘤导航员在患者的首次就诊时与他们会面，并在整个治疗过程中协调护理。将队列分为两组：在实施肿瘤导航员之前评估的患者和在实施肿瘤导航员之后评估的患者。比较患者的人口统计学特征和从首次就诊到首次干预的时间。
共有 147 名新诊断为胰腺肿瘤的患者接受了评估；57 名患者在肿瘤导航员计划开始前接受评估，79 名患者在导航员计划实施后接受评估。单因素分析显示，首次由任何提供者接触到干预的时间在肿瘤导航前为 46 天，在肿瘤导航实施后为 26 天（p=0.005）。在控制其他协变量后，肿瘤导航员的使用将首次由任何提供者接触到干预的时间缩短了近 16 天（p=0.009）。
实施肿瘤导航员计划显著缩短了胰腺恶性肿瘤患者的治疗时间。
