Hearing that you may have a colorectal cancer diagnosis is a stressful time, and can be full of anxiety for patients and families. However, a new virtual model of care for patients with colorectal cancer means that some patients who were limited to colorectal support based on geographic location are now able to get information on the care journey, have diagnostic tests coordinated and receive patient navigation support over the phone.
“It was incredibly comforting to know that there was someone I could call who would help me plan my appointments and answer all of my questions without having to leave the comfort of my home,” says Susan Burman, a patient who used the new model. “Knowing all I had to do was pick up a phone and call one person with my questions was a huge relief and allowed me to concentrate more on my health and getting through this period.”
Under this new navigation model, patients outside of Kingston who are diagnosed with or have high suspicion of colorectal cancer are immediately referred to the Colorectal Diagnostic Assessment Program (CDAP) and connected with a Patient Navigator who ensures that their staging imaging tests done at Kingston Health sciences Centre (KHSC) are scheduled and completed within a timely manner. In addition, the Patient Navigator consults with the patient over the phone for their initial assessment and helps with any of their questions or concerns.
The idea for the service came as a result of a review of the wait times and accessibility that patients had to the CDAP program. Patients with or suspected to have colon cancer who are seen outside of Kingston but require the diagnostic tools and services offered at KHSC, often faced longer wait times and no connection to the Patient Navigator. In an effort to help provide equitable care to all patients in the southeast region, the CDAP program successfully submitted a quality improvement idea to Health Quality Ontario to trial a virtual navigation model.
“We understand that the waiting period can exasperate patient’s anxiety as well impacts when a patient can begin treatments,” says Erin Brown, interim manager of the South East Regional Cancer Program. “When the patient is not getting the right care at the right time, the efficacy of the treatment and patient health outcome can be negatively affected, which is why we explored what other models of care could help improve this.”
In the new model, patients are referred into the CDAP program where the Patient Navigator ensures that their staging tests are expedited and prioritized appropriately as well connects with the patient over the phone to offer support and provide information to supplement their doctor’s visit.
“As a virtual navigator I am able to help connect patients with resources and services and work on their behalf with Diagnostic Imaging to ensure that their staging and tests are being done with the stipulated Cancer Care Ontario guidelines,” says Jessica Holmes, Patient Navigator for the CDAP program. “Though this doesn’t replace the ideal model of in-person meetings and discussion, we are able to offer patients outside of Kingston a level of navigation support that they didn’t have before.”
For Susan, having the information and reassurance of someone to connect with before coming to Kingston for her staging tests was a huge relief.
“I’ve had a lot of experiences with hospitals and this was the best experience ever,” says Susan. “I’ve never had that kind of contact and I felt so much better informed and secure in the care I was receiving. Even if there was something you forgot, which a lot of times going through this you do, I knew I could always call Jessica for support and that was very reassuring.”
Moving to this model has also been a huge benefit for physicians who work with colorectal cancer patients outside of Kingston. Having access to the Patient Navigator and the CDAP program has meant knowing the staging will be done in a timely manner and that their patients are receiving navigation support and resources.
“I am incredibly appreciative of the assistance that our patients and physicians receive and I have found this program to be of tremendous value as we can get our patients staged in an efficient way,” says Dr. Khokhotva, a physician with the Lennox and Addington County General Hospital in Napanee. “The care treatment depends on the results of the diagnostics and it’s been very helpful to work with the CDAP program and to be able to make having these staging requests done in a much more streamlined and timely process.”
This model was initially launched in September 2017 at the Lennox and Addington County Hospital in Napanee and plans are in place to expand to Brockville General Hospital. To date, over 10 patients have been referred for this service.