Utilization outcomes of a cancer rehabilitation (CRNav) program: getting to the quadruple aim in cancer care

BackgroundA cancer rehabilitation navigation (CRNav) program is an evidence-based care delivery model that uses a rehabilitation professional in the navigation role to support oncology care delivery, provide functional screening for early identification of impairment, and coordinate care delivery services to optimize early rehabilitation. There is limited research showing how a CRNav impacts healthcare utilization. The objective of this study was to assess utilization data for a CRNav Program and demonstrate how the program influences the effectiveness of cancer care delivery and patient and provider satisfaction.MethodsData was collected from the electronic health record of the Brooks Rehabilitation/Halifax systems at a community cancer center to assess program and service utilization over 3.2 years using a retrospective design.ResultsOver 3.2 years, the CRNav program received 1585 referrals and screened 1447 (91.3%) patients. Of the 1447 screenings performed, 73.6% were recommended to receive outpatient rehabilitation (n = 1065). Among patients screened, breast cancer was the most common cancer diagnosis (47%) followed by head and neck cancers (14%). There were 638 total rehabilitation visits identified for patients who were seen for services within the health system, with physical therapy encounters accounting for the greatest number (n = 462). The most common reasons for receiving physical therapy services included lymphedema (27%), pain (25%), and limited range of motion (12%). Patients reported high satisfaction (>= 95.4%) in the areas of how well rehabilitation met expectations and overall satisfaction with the rehabilitation experience.ConclusionsUsing a CRNav in a community cancer center resulted in efficient care of patients with cancer, improved patient satisfaction and patient outcomes, and an enhanced clinician experience. This program provides a value-based approach to care supporting the quadruple aim and improving the identification and management of cancer-related functional morbidity.