Nurse navigators help radiology departments contribute to value-based care, study charges

Using nurse navigators can help radiology departments contribute to the value-based care movement, according to a new study published June 3 in Clinical Imaging [1].

Beth Israel Deaconess Medical Center established its own program with the goal of enhancing the patient experience after a breast biopsy, along with improving timeliness and care coordination. Leaders also aimed to bolster direct communication between patients and the radiology department while increasing retention in the health system.

Researchers recently sought to measure the program’s success, analyzing data from six months before and six months after implementation. They found marked gains in certain key metrics: 71% of patients had breast pathology results communicated directly to them post-intervention versus 4% before. BIDMC also saw improved documentation of pathology results following the change.

“Imaging nurse navigation is one way radiology departments can contribute to value-based care, with greatest value added by timely and direct result and recommendation communication to patients (closed-loop communication),” Melissa F. Tannenbaum, MD, a radiology resident at the Boston-based institution, and co-authors concluded.

BIDMC’s breast program previously utilized nurse navigators. However, they were tied to other cancer care disciplines such as surgery and oncology and were not engaged with patients until after they elected to receive cancer care. The new imaging-based role was established in May 2018 after approval by hospital leadership. Duties include calling patients the day after their biopsy to see how they’re doing, phoning again with pathology results and recommendations from the radiologist, and communicating results to the referrer. The position also helps facilitate appointments at the breast care center, communicate the need for any additional imaging or follow-up care, and ensure documentation of all this in an addendum to the biopsy report.

For the study, Tannenbaum and co-authors analyzed EHR data covering May-October 2017 leading up to the change and May-October 2019 afterwards. The final sample included 498 patients in the pre-navigation group and 526 more treated after the intervention.

BIDMC saw gains in direct communication with patients, without any corresponding increase in overall time of result communication. However, because of factors outside the radiology department, the time between biopsy to pathology report, result communication to initiation of care, and biopsy to surgery all increased. Meanwhile, both groups saw high compliance and care retention.

“Future studies evaluating external factors of the multidisciplinary team (pathology, surgery, medical/radiation oncology), and analyzing patient, radiologist, and referring provider satisfaction with nurse navigation could potentially shed light on additional advantages of a nurse navigator program,” the authors advised. “Overall, a successful nurse navigation program must be tailored to meet the specific needs of the radiology practice and patient population it serves in order to be useful and beneficial,” they added.

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