Improvement Spotlight
Helping Patients with Chronic Lymphocytic Leukemia (CLL)
A chat with Nan Cox-Kennett, Nurse Practitioner with the Hematology team at the Cross Cancer Institute.
What was the problem you encountered with CLL patients?
Imagine logging into MyAHS Connect and seeing a pathology report that reads: “consistent with chronic lymphocytic leukemia (CLL)”. You’re left wondering—what is CLL? What does this mean for your life? You turn to the internet for answers, diving deep down the rabbit hole of Dr. Google. You begin trying various supplements, unsure if they’re helpful. You might have a family physician doing their best to support you, but the wait to see a specialist stretches on.
In the fall of 2024, this was the reality for many patients at the Cross Cancer Institute, where a shortage of specialists and clinic space led to longer than normal wait times for a hematology consult.
That’s a tough situation for patients. What did you do to change things?
Ideally, hiring more staff and expanding clinic space would be the solution—but those changes take time. One of the biggest challenges we noticed was that when patients finally had their appointments, a significant portion of the time was spent addressing misinformation they had gathered during their wait.
We asked ourselves: What if we could offer a group teaching session via Zoom, led by the Nurse Practitioner for Hematology?
The hematology team supported the idea, but we faced logistical hurdles. We needed to figure out how to conduct group sessions while maintaining patient privacy and obtaining consent—especially since many participants would be learning about their cancer diagnosis for the first time.
That sounds complicated. How did you address those challenges and can you tell us about the sessions?
After reviewing the waitlist, we found that about 30% of patients had early-stage CLL that didn’t require treatment. These individuals also had no language or cognitive barriers. Another 20% had a pre-cancerous (non-malignant) condition. Together, this made up 50% of the waitlist—an ideal group for virtual education.
We consulted with the legal team and developed an invitation letter for a group teaching session titled “Understanding Your Blood Results.” Patients who contact the clerk to participate are considered to have given consent to receive information in a group setting.
We created two separate sessions: one for CLL and another for non-malignant conditions.
A virtual clinic was set up within Connect Care where staff can book patients into sessions. Prior to the session, each patient receives in the mail a one-page instruction sheet with Zoom login details.
When patients join the session, a clerk helps them log in and, if the patient prefers to remain anonymous, change their Zoom profile name to Anonymous. They are also given the option to turn their camera on or off. Once set up, they are admitted into the Zoom room.
Each session lasts 30-45 minutes and includes a PowerPoint presentation, open discussion, and general questions about the diagnosis. No personal health information is shared. Patients remain on the waitlist in their original position and later receive an in-person consult with a specialist.
What has the impact been? Are the virtual sessions helpful?
The response has been overwhelmingly positive. About 90% of invited patients participated in the virtual sessions. Many expressed gratitude for the clear, accessible information.
Patients have expressed that they feel better informed when they arrive for their first consult and are prepared with relevant questions. As a result, appointments are more efficient, and clinics run more smoothly.
Overall, the virtual teaching sessions have had a meaningful and positive impact—both for patients and the hematology team.
Nan Cox-Kennett is a Nurse Practitioner with the Hematology team at the Cross Cancer Institute. She is a valued team member with over 23 years of experience. Nan is passionate about finding practical solutions to address challenges for patients.
