This past spring, Kim Parham’s mother fell in her home and was on the floor for six hours. She had Life Alert and a cell phone in her pocket, but was too confused to use these tools to call for help.
She was finally able to gather herself long enough to crawl to a landline phone and get help. Fortunately, nothing was broken. She injured her knee and required rehab. Parham says she took this experience as a sign.
At the time of the fall, Parham, RN, BSN, CN-BN, was a cancer support program director at Nashville-based Saint Thomas Health.
“This was a wake-up call for me,” she recalls. “I thought this may be an opportunity to spend some time with my mother, get her the proper care she needed, and reflect on my work. I loved helping people, and I wanted to help even more than I could in my role. What I concluded was that this was the time for me to venture out on my own.”
To do so, she founded Lung Cancer Solution, which offers a variety of services to aid in the continuum of lung cancer care, in June 2016.
“I was able to do a lot of the setting up of the company while I was helping my mother get well,” she says. “I think her fall was a blessing in disguise. She is now in assisted living and enjoying it, and I’m enjoying what I’m now doing. I’m in a position to hopefully help the nation and the world through Lung Cancer Solution.”
During her 30-year career in healthcare, Parham has created and implemented numerous cancer support programs, including breast health and screening navigation programs and an incidental nodule program.
Through these experiences, she has identified three components that are critical for a multidisciplinary support program to succeed. Here is her triad.
1. Physician champion. After Parham left Saint Thomas Health, she asked the organization’s chief operating officer for some marketing advice.
“I said, ‘Do you feel with what I can offer, should I market to administrators, navigators or should I reach out to the surgeons, pulmonologists and/or physician groups?'” Parham says. “Her response was that administration can buy all of the equipment in the world, but if you don’t have a physician champion to use it, it’s going to sit there. The physician champion would be where I would focus if I wanted to get physicians engaged and excited to make a difference through a lung program.”
That advice has remained in the back of her mind ever since.
“For a program to succeed, it needs a physician champion, and the right one at that,” she says. “This champion not only needs to be engaged, but respected by peers as well. You might have a physician who is engaged but if he or she can’t get other physicians to see the benefit of the program, it won’t matter. Without a champion, a program may not be the best it can be or the most cohesive it can be.”
A physician champion can have a lot of pull in many areas, Parham notes. For example, a champion may be able to convince other physicians to attend multidisciplinary conferences. “Once that physician champion engages them in conversation about the value of a conference and gives them an opportunity to share their knowledge about what they feel is best for patients, it can have a rippling effect on other physicians. A physician champion can pull the program together with their peers.”
2. Engaged administration. An engaged administration plays a number of critical roles in the success of a multidisciplinary program, Parham says. “You’re going to need administration on board to support the physicians and their champion, making sure they have the equipment and tools they need to succeed. Administration will have to approve the team members necessary for the program to function properly.”
Administration will also need to approve allocation of time for the program. “Staff time is really underestimated, especially in the beginning of a program,” Parham says. “If you want a true comprehensive lung program, where you have a screening component, incidental finding follow up, lung nodule clinic, regular multidisciplinary conferences and survivorship, it will take time to develop and implement all of those components.”
As such, education of administration might be necessary to achieve their engagement. “Administration needs to be made aware that all of this won’t just happen from the get go,” Parham notes. “As with the physicians, you may need to have someone who will be a champion in administration for you, whether that’s an oncology service line executive or perhaps someone from medical imaging.”
She adds, “Once administration truly sees the benefit of the program, they will allocate the resources, time and equipment that’s needed.”
3. Right clinical team. The final piece of the Parham’s triad: assembling the best team, and assigning them to their appropriate roles.
“I am a believer that you need RNs to be central at the nurse navigator role,” she says. “They can be supported by patient navigators (LPNs) and lay navigators, but I do think you need an RN overseeing the program. Then you have the other ancillary team members who contribute so much to the team. By adding the ancillary team members, you have a continuum of patient-centered care that meets patients’ needs. Included in this team are dietitians, social workers, physical or occupational therapists, respiratory therapist/pulmonary rehabilitation, palliative care and chaplains.”
Parham notes that administration is likely looking for a good team that focuses on cost-effectiveness and efficiency, and ensuring all team members are practicing to their proper scope of licensure or certification.
Parham says her goal is to have an impact through more early-stage diagnoses. “With early-stage diagnosis, patients — and their families — can have a better quality of life.”
Contact Parham at firstname.lastname@example.org.