Development of a nurse-initiated proactive telephone nursing assessment guideline for new cancer patients.

Telephone practice is an essential component of ambulatory nursing practice to address patient concerns between their clinic visits. Proactive telephone practice has been part of oncology nursing at a large regional cancer centre for six years and involves taking the initiative of calling patients and families before they are in distress. A review of nursing practice regarding proactive calls in the centre revealed a lack of standardization across cancer disease sites in identifying and assessing patients who would benefit from proactive calls, and variability in how nurses documented telephone interactions. To create a standardized approach for proactive telephone practice, we began by identifying when patients require a proactive call based on key transition points across their cancer care trajectory. Based on the practice review of proactive calls, the needs assessment with patients, and a literature review, a Proactive Telephone Nursing Assessment Guideline was developed. The guideline provided guidance for conducting a proactive telephone call and identifying patient needs, intervening as required, and documenting the exchange. The guideline was piloted with newly diagnosed patients to determine if the call helped in meeting their needs. Informational and practical needs were most common. The pilot revealed both patients and families were satisfied with the proactive call. Nurses felt the guideline was useful, but could be burdensome, especially when it was first used. Through the pilot, it was identified that proactive telephone calls can be utilized to focus on patient and family supportive care needs.

The Live Voice Answer initiative: Supporting oncology patients beyond the clinic.

In 2016, a Live Voice Answer symptom management and distress telephone line was developed at a large regional cancer centre in Toronto. Prior to the initiation of Live Voice Answer, the previous telephone practice involved patients leaving a voicemail message for a nurse without a definitive return call time. An interprofessional team, including patient partners, sought to address this drawback and ensure all patients living with cancer have access to a nurse in real time (live voice) when they called the centre. After piloting the feasibility of real time telephone access, the Live Voice Answer initiative expanded beyond the pilot to meet the needs of all patients and families. Overall, the Live Voice Answer initiative has led to marked improvements in patient satisfaction compared to the pre-pilot state and timeliness of telephone access for patients and their families. This article describes the Live Voice Answer initiative, process improvements, and evaluation results.