title: Initial Experience of a Patient Navigation Model for Head and Neck Cancer.
abstract: OBJECTIVE
  Specific temporal goals for treatment of head and neck cancer (HNC) are common in Europe but not in the United States. We implemented a patient-centric navigation model with an aspirational goal that all patients will receive treatment recommendations within 2 weeks of presentation as a means to improve outcomes in our patients with HNC.
  
  
  OBJECTIVE
  To assess the temporal impact of using an aspirational goal in a patient-centric navigation system on the time from presentation to formulation of treatment planning for patients with HNC.
  
  
  METHODS
  Retrospective review of 100 consecutive patients treated for squamous cell carcinoma of the head and neck at a tertiary referral center between 2011 and 2014. Patients were assessed to determine the efficiency of a patient-centric navigational model in delivering cancer treatment recommendations. This model was designed with an aspirational goal of providing treatment recommendations within a 2-week period.
  
  
  METHODS
  Starting in 2011, patient-centric navigation model including the assignment of a nurse who acts as a patient navigator.
  
  
  METHODS
  The time interval between presentation to clinic and definitive treatment recommendations, as well as factors associated with delay.
  
  
  RESULTS
  Of the 93 patients who met inclusion requirements, most were white (81 [87%]) males (74 [80%]) with a mean (SD) age of 63.4 (10.8) years insured by Medicare or Medicaid (64 [69%]). Forty-seven (51%) received treatment recommendations within the 2-week period, with median and mode values of 15 and 14 days, respectively. The mean (SD) interval was 18.8 (18.6) days. Outliers included 2 patients with synchronous lung nodules (72 and 85 days) and 2 patients with psychosocial barriers (107 and 86 days). There were no significant differences seen for the mean (SD) time interval with respect to patient race (blacks, 17.6 [15.7] vs whites, 22.5 [30.0]; P = .20), sex (males, 18.3 [18.1] vs females, 20.4 [19.7]; P = .13), insurance status (insured, 16.3 [10.2] vs uninsured, 19.8 [21.0]; P = .24), and stage at presentation (stage I, 14.4 [17.0] vs stage II, 11.0 [5.3] vs stage III, 14.7 [8.6] vs stage IV, 21.2 [20.2]; P = .40).
  
  
  CONCLUSIONS
  The goal of treatment recommendations for HNC within 2 weeks was shown to be reasonable and attainable. Further research should address the delays encountered by patients with psychosocial barriers and those with synchronous lung nodules.
authors: Department of Otolaryngology, Tulane University School of Medicine, New Orleans, Louisiana.
authors: Jason F
authors: JF
authors: Ohlstein
authors: Department of Otolaryngology, Tulane University School of Medicine, New Orleans, Louisiana.
authors: Sabrina
authors: S
authors: Brody-Camp
authors: Department of Otolaryngology, Tulane University School of Medicine, New Orleans, Louisiana.
authors: Starr
authors: S
authors: Friedman
authors: Department of Otolaryngology, Tulane University School of Medicine, New Orleans, Louisiana.
authors: Joshua M
authors: JM
authors: Levy
authors: Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana.
authors: Joseph F
authors: JF
authors: Buell
authors: Department of Otolaryngology, Tulane University School of Medicine, New Orleans, Louisiana.
authors: Paul
authors: P
authors: Friedlander
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery*; D017598:Efficiency, Organizational; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration; D006785:Hospitals, University; D006801:Humans; D008145:Louisiana; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000473:pathology / Q000601:surgery*; D062526:Patient Navigation / Q000458:organization & administration*; D012189:Retrospective Studies; D016896:Treatment Outcome; D057188:Workflow