Benchmark- Create a Workflow
Part 1: Analysis of Current State
Oncology navigators are designed to make it easier for all oncology clinicians to see their documentation. Cancer patients’ navigation programs have also reported increased access to and utilization of cancer care among underserved and poor individuals. The Oncology Navigators contain basic information and contact methods, patient health questionnaire, patient’s information from other healthcare providers, and etiquette and standard clinic procedures.
There is mounting evidence of the value of Oncology Navigators, however, they are not universally understood or provided. Various health institutions have created an Oncology Navigator Recommended Design Document that could be used at Universal Health. Both Oncology South and Oncology North have position navigators that offer discrete data reports and the electronic documentation used has forms and Free-text notes that are shared by all types of navigators (Braun et al., 2012). However, there is a need for understanding the unique data requirements for the navigators and in-take forms that offer prior authorization thus forming a foundation for the development of appropriate discrete fields or using existing data fields such as ICD10 to help organize and sort data.
Some of the improvements that are needed in these navigator forms as they get integrated into the HER should include a notice for privacy practices that involves acknowledging patients’ privacy rights and privacy practices. Since information obtained from these forms may be used for research, special allocations should be included where patients give consents for research and publications (FileHold, 2021). Further improvements that need to be made should include education and outreach, screening performed, cancer staging, and diagnosis, survivorship, and end-of-life programs given to the patient.
Part 2: Proposed Future Workflow
Part 3: Rationale
The users of the future workflow would include oncology nurses, oncology clinicians, oncology pharmacist, and other relevant healthcare professionals that work in cancer centers. In the current state of the Oncology North Intake form and Oncology South, there is a lack of guidance on how the clinicians, physicians, nurses, and pharmacists should utilize the workflow, and practice policies are not instituted to support patient safety when the system is being used (Shulman et al., 2008). Within the proposed improvements, the workflow will be organized to accommodate effective ordering, preparation of the patient, and administration of chemotherapy. The proposed workflow puts into account the cancer care continuum which is the phases through which an individual move to prevent and control cancer.
The workflow thus provides a continuum that is depicted linearly from prevention to end of life, however, the phases may overlap and repeat. Inclusion of counseling and rehabilitation to cancer patients would be an ideal adjustment to the Oncology North and South and should be singled out as a phase of the cancer care continuum (Pebanco, 2021). The future workflow will follow a string of phrases that involves education and outreach, screening, diagnosis and staging, treatment, survivorship, and end of life.
The future workflow used hand-in-hand with electronic documentation ensures that every phase of the electronic documentation is handled independently, and order introduced into the processes in a more transparent, robust, and dynamic fashion making it a key part of the document lifecycle. The workflow would streamline the approval and review process of the documents as they proceed through each phase and the EHR developed will improve collaboration among the various healthcare providers involved in the care for oncology patients.
The workflow will allow the EHR system to be more flexible and allow users to make their workflow processes either be more straightforward or possess the required complexity. The future workflow will allow the EHR documents/system to be triggered/ initiated as multiple or single documents (Helmlinger et al., 2019). The multiple documents in the workflow may possess both main documents and supplementary documents in which case the main documents are the ones being approved while the supplemental documents only assist in the review process.
The workflow will massively assist in patient care and improve the outcome of oncology patients’ treatments. The phases in the workflow will ensure that the navigators take steps to ensure that cancer information is more understandable to the patients so that they can actively and fully participate in the treatment and care process thus improve patients'/clients’ satisfaction with care. The future workflow navigators will also allow the oncology clients to learn about the available oncology services and allow care to be more accessible to patients by assisting clients to make and keep appointments, complete the forms, find transportation, and comprehend instructions. It ensures the oncology clients understand the process of care that brings holistic outcomes thus improved survivorship. Detailed information records will be available within the workflow EHR to support medical research upon clients’ provision of consent for the use of their medical information. Patients’ trust in the confidentiality of the information provided will be elevated by the creation of a phase that provides dictates of information security and privacy (Helmlinger et al., 2019).
The future of the workflow is expected to change to meet the upcoming innovations and the evolution of cancer care and to allow the preparation and inclusion of value-based care in the future. The continuous development of new evidence and technologies will expand oncology services to a broad number of cancer patients and may introduce more complex strategies and programming tactics that may eventually necessitate a new era of workflow in oncology care. The future state workflow was developed by evaluating the current and discovering deficiencies then developing the flow diagram in Microsoft word to indicate the phases. The improvement plan for future state work was based on analysis of evidence that is constantly being developed on cancer and establishing strategies of evaluating existing workflow at every given time (Helmlinger et al., 2019).
Braun, K. L., Kagawa-Singer, M., Holden, A. E., Burhansstipanov, L., Tran, J. H., Seals, B. F., Corbie-Smith, G., Tsark, J. U., Harjo, L., Foo, M. A., & Ramirez, A. G. (2012). Cancer patient navigator tasks across the cancer care continuum. Journal of Health Care for the Poor and Underserved, 23(1), 398-413. https://doi.org/10.1353/hpu.2012.0029
FileHold. (2016, November 30). Document Workflow for Review and Approval. FileHold.
Retrieved from https://www.filehold.com/features/optional/workflow
Grand Canyon University. HCI-670 Oncology North Intake Form.pdf
Grand Canyon University. HCI-670 Oncology South Intake Form.pdf
Grand Canyon University. HCI-670 Case Study.docx
Helmlinger, G., Sokolov, V., Peskov, K., Hallow, K. M., Kosinsky, Y., Voronova, V., Chu, L., Yakovleva, T., Azarov, I., Kaschek, D., Dolgun, A., Schmidt, H., Boulton, D. W., & Penland, R. C. (2019). Quantitative systems pharmacology: An exemplar model‐building workflow with applications in cardiovascular, metabolic, and oncology drug development. CPT: Pharmacometrics & Systems Pharmacology, 8(6), 380-395. https://doi.org/10.1002/psp4.12426
Pebanco, G. (2021, May 7). Development of a comprehensive nurse navigation intake form. Journal of Oncology Navigation & Survivorship. https://www.jons-online.com/issues/2020/november-2020-vol-11-no-11/3211-development-of-a-comprehensive-nurse-navigation-intake-form
Shulman, L. N., Miller, R. S., Ambinder, E. P., Yu, P. P., & Cox, J. V. (2008). Principles of safe practice using an oncology EHR system for chemotherapy ordering, preparation, and administration, Part 1 of 2. Journal of Oncology Practice, 4(4), 203-206. https://doi.org/10.1200/jop.0847501