University of Illinois Cancer Center patients are self-isolating due to the COVID-19 pandemic, but they are not alone.
Since cancer doesn’t stop, neither do UI Cancer Center navigators. Either via computer or telephone, the navigation team is helping guide patients through the healthcare system so they can continue to receive the care and treatment they need. As part of the Community Engagement and Health Equity (CEHE) office, patient navigators explore ways to assist community members with all facets of their life and develop services based on their unique requirements, especially those who have been marginalized during the coronavirus pandemic.
“COVID-19 has brought to the forefront the work that our office is already undertaking to address racial health disparities,” said Jeanette Gonzalez, MS, project manager of community-based initiatives at the CEHE office. “Our work is even more important during this crisis. Our communities of color have been the hardest hit by the coronavirus, especially given the prevalence of underlying health conditions our patients are experiencing – hypertension, obesity, chronic lung disease, diabetes and cardiovascular disease.
“While our team has been following Governor Pritzker’s order to shelter-in-place, our team of navigators continue to engage with community members who have been directed through our screening programs.”
On March 20, the CEHE team began rapidly formulating a strategic plan on how to assist their patients. They did not want them to feel abandoned and wondering how they would receive help in their battle against cancer. The CEHE team initially developed internal training materials to familiarize themselves with the virus, and discussed the best ways to inform patients about the available resources within their catchment community, for preventing and protecting themselves from it, and overcome barriers to access care should anyone be diagnosed with the disease.
“Our navigators needed to adjust and adapt to a new rapidly changing work environment, and training the team for COVID-19 and gathering the general resources available was essential, as the navigators may be the first contact for patient’s to receive answers regarding the virus and disease,” said Nasima Mannan, MPH, senior research specialist/navigation manager.
Once the training was complete, the four navigators – Paola Torres, Ivanhoe Hall, Miguel Negrete and Ryan Stratton – began working remotely with their patients. Since smokers are more vulnerable to adverse health outcomes due to respiratory illnesses such as COVID-19, it was imperative that the navigators continue its adult smoking cessation program, Mi-Quit II. Using electronic medical records (EMRs), navigators were able to access patient information remotely and contact patients to continue providing tobacco cessation services.
Smokers who have kicked the habit may have a tendency to revert to their old ways in trying times. Navigators are following-up with these patients and community members to help them remain smoke-free, or provide them assistance if they have returned to smoking. The majority of those contacted participated in the UI Cancer Center’s Freedom From Smoking clinics in 2018 and 2019.
Education is also being provided to patients who qualify for low-dose computed tomography (LDCT), an X-ray procedure that produces images of a person’s lungs used to detect abnormalities. Once the COVID-19 threat is over, Mi-Quit II navigators will follow-up with them to ensure they are connected with their medical care provider and are receiving cancer screening as needed.
Colorectal cancer screenings, performed primarily through a fecal immunochemical test (FIT) and colonoscopy, have been temporarily suspended, as non-essential medical services are rescheduled or cancelled to protect patient’s exposure to COVID-19, Mannan said. For patients who received an abnormal colonoscopy (polyps that were benign, precancerous or cancerous) prior to the postponement, navigators continue to maintain contact with them and answer any questions or concerns that arise.
“The navigators are also using cancer screening and tobacco cessation services as an opportunity to perform a COVID-19 welfare check with the patients and community members,” Mannan said.
The UI Cancer Center has a large volume of patients who are referred to them for breast cancer screening through its Mi-MAMO program. The second Wednesday of the month at the UI Health Mile Square Health Center’s main location, 1220 S. Wood St., is devoted to breast cancer screenings for women who do not have an appointment. The program has been temporarily suspended due to the current circumstances.
Navigators are also contacting any patient whose screening or diagnostic breast cancer appointment has been cancelled or rescheduled, providing them with updates on their appointment, and rescheduling it if need be.
“Many of the patients needing diagnostic screenings are afraid and nervous about their health, especially if their appointment has been cancelled or rescheduled,” Gonzalez said. “Our navigators are working closely with the radiology team, patient providers and patients to keep them informed, and our patients are happy to hear from them, especially when providing them with updates on COVID-19 and their appointments.”
In 2019, navigators assisted 1,631 patients through the various health prevention programs at the UI Cancer Center. Navigators participated in 50 community health awareness events, and engaged with 8,530 community members.
The pandemic has forced hospitals and clinics to revise policies more rapidly – sometimes several times daily – and navigators must stay informed to support their patients, Mannan said. To do so, “navigation huddles” have been implemented, with team members meeting at the beginning and end of each day to discuss clinical and hospital updates, testing guidelines and updates, new resources, and information regarding COVID-19. With navigators spending hours on computers and telephones addressing the needs of their patients, it can wear on a person’s emotional health.
“We try to lighten things up in the huddle meeting,” Mannan said. “At the end of the meeting we participate in an activity that isn’t work-related. It initially started with sharing a favorite photo, and continued with movies, music and food discussions. Each day a team member selects a topic of their choice and uses it to raise team morale.
“It’s been a stressful time not only for our patients but also our navigators. But our team has done a great job, and I am really proud to be a part of it. Everyday has been a learning lesson for us, and we continue to grow under these unprecedented times. ”