The Duke Endowment of Charlotte, N.C., has awarded a three-year, $600,000 grant to UNC Lineberger Comprehensive Cancer Center to establish a multi-institutional lay patient navigation program aimed at improving cancer outcomes in North Carolina.
Thomas Shea, MD, associate director for Outreach Programs at UNC Cancer Network, and Jean Sellers, RN, MSN, clinical administrative director at UNC Cancer Network, will use the funding to implement the UNC Lay Patient Navigation Program in 10 hospitals and cancer care facilities that collectively cover a wide geographic region of the state. They are:
- Caldwell UNC Health Care, Lenoir
- CarolinaEast Cancer Center, New Bern
- Duke Cancer Institute, Durham
- Mission Cancer Care, Asheville
- Nash Health Care, Rocky Mount
- Pardee Hospital, Hendersonville
- Seby B. Jones Regional Cancer Center, Boone
- UNC Lenoir Health Care, Kinston
- Vidant Medical Center, Greenville
- Zimmer Cancer Center, Wilmington
Sellers, who has spent much of her 25-year oncology nursing career working with community and rural cancer centers, said there is a growing demand for cancer care and a shrinking workforce. Health care providers, as a result, are spending an increasing amount of time addressing acute care problems, which leaves less time for non-clinical care, such as emotional and social support or financial counseling.
"We know that both clinical and non-clinical care are critically essential to the patient's overall well-being," said Sellers. "Accomplishing this requires a team approach which benefits from the professional health care providers and lay navigators working together. Lay navigators have demonstrated they can help to eliminate financial concerns, improve communication and overcome medical system barriers faced by patients both in the community and throughout their treatment.
"The key to the success of this program is ensuring lay navigators have the skills to provide this level of support. Equally important is our need to monitor their level of compassion fatigue, which can lead to burnout if not addressed," said Sellers, who is president of the North Carolina Oncology Navigator Association and has served in a leadership role in the Oncology Nursing Society's nurse navigation special interest group.
In 2009, the UNC Cancer Network developed a training curriculum and model of patient navigation that paired volunteers with health care teams to address critical components of non-clinical support in eastern North Carolina. The volunteers have demonstrated their ability to identify and acquire critical resources patients need when faced with inadequate financial resources, lack of transportation or lack of social support. Today, the program is expanding throughout the NC Cancer Hospital. Volunteers include cancer survivors, caregivers, community members, retired health care providers and pre-med students.
Although the patient navigator field is still developing – there currently are no national standards for lay patient navigator training programs – UNC Lineberger has developed a model that the Advisory Board, a national health care consulting firm, rates as one of three best practices of patient navigation in the United States.
Shea said The Duke Endowment grant will be used to train professionals across the state to develop and implement a program that replicates this model within each care facility. As envisioned, the new program will use brief interactive presentations and a training manual that will help the lay navigators develop the skills, as well as provide them with the tools, they will need to offer support for patients undergoing cancer treatment.
"Despite advances in cancer detection, prevention and treatment, cancer still takes a terrible toll on the personal and community level," said Shea, who is also the medical co-director of the UNC Bone Marrow Transplant and Cellular Therapy Program and the John William Pope Distinguished Professor in Cancer Research at UNC School of Medicine. "Each year, more than 56,000 cases of cancer are diagnosed in North Carolina. By making lay patient navigation programs more widely available across the state, we can help people receive better cancer care by alleviating the burden the disease places on so many."
Shea and Sellers expect the first program to be developed and operational this fall, and for all 10 programs to be in place by the end of 2018.
About UNC Lineberger
The University of North Carolina Lineberger Comprehensive Cancer Center, located in Chapel Hill, is one of the country's leading cancer centers. UNC Lineberger earned the National Cancer Institute's highest rating of exceptional, and is one of only 48 National Cancer Institute-designated Comprehensive Cancer Centers. With research that spans the spectrum from the laboratory to the bedside to the community, UNC Lineberger faculty work to understand the causes of cancer at the genetic and environmental levels, to identify approaches to improve the prevention and early detection, and to translate scientific findings into pioneering and innovative clinical trials.
About The Duke Endowment
Based in Charlotte and established in 1924 by industrialist and philanthropist James B. Duke, The Duke Endowment is a private foundation that strengthens communities in North Carolina and South Carolina by nurturing children, promoting health, educating minds and enriching spirits. Since its founding, it has distributed more than $3.4 billion in grants. The Endowment shares a name with Duke University and Duke Energy, but all are separate organizations.