Program Description
City of Hope, one of the largest and most advanced cancer research and treatment organizations in the United States, ranked among the nation’s top five cancer centers by U.S. News & World Report, recognized a critical need to better serve its most vulnerable patients—older adults, particularly those facing language barriers. An American Cancer Society (ACS) grant was awarded to a multidisciplinary group that included City of Hope’s department of supportive care medicine, center for cancer and aging, and population sciences program. This support enabled City of Hope to further strengthen navigation services, allowing it to launch the Enhancing Vulnerable Elderly Navigation (EVEN) Program. The goal was to expand the capacity of its patient navigation program to provide high-quality, evidence-based oncology navigation services tailored to the unique needs of older cancer patients with other important vulnerabilities like language barriers and hearing impairment.
The EVEN Program aims to address several challenges vulnerable older adults face in navigating complex cancer care. These challenges include limited standardization of navigation protocols, barriers related to language and literacy, and difficulties accessing essential resources. To address these issues, City of Hope formed a Community Advisory Board (CAB) that included representatives from community organizations such as the Cancer Support Community, ACS, and Cancer Legal Resource Center. This collaborative approach ensured that the program’s design and implementation were informed by the diverse needs of the older adult patient population.
Impact
The program has had significant achievements, including:
- Development of a daily Tableau report that identifies new patients 65+ years of age and, specifically, patients 65+ years of age whose primary language is not English. The report enables navigators to prioritize these patients for assistance.
- Navigation team members received specialized training in geriatrics to support the needs of older cancer patients.
- Use of an interpreter app was systematically incorporated into workflows, enabling navigators to more effectively serve patients whose primary language is not English.
- A navigation template in Epic was significantly streamlined, reducing the time required to document, enabling navigators to focus more time on assisting patients.
- Many older adults were found to need inexpensive “pocket talkers” to enhance their communication ability while they received care at City of Hope.
The outcomes of the EVEN Program have been promising. By automating patient identification and standardizing navigation procedures, City of Hope has seen significant improvements in its ability to quickly and effectively support vulnerable older adults through their cancer journey. The program identified and addressed hundreds of barriers to care, and navigation was reoriented to those who need these services most.
“City of Hope’s navigation services for older adults were significantly improved through this grant, and permanent adjustments were made to more efficiently deploy our services,” said Annette Mercurio, City of Hope director of patient and family services. “We’re confident that the long-term outcomes for the most vulnerable patients will be improved when the final analysis is completed.”
The program’s successes demonstrate the impact of tailored, community-informed strategies that improve supportive care coordination and access for older cancer patients, ultimately contributing to better health outcomes and a more coordinated and personalized approach to care.