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Introduction toPatient Navigation

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What Is Patient Navigation?What Is Patient Navigation?

Patient navigation:– Supports patients in need of assistance with

one-on-one contact– Ensures that all patients with suspicious findings

receive a resolution to those findings– Utilizes a patient navigator who moves patients

through the health care system– Works within the organization and through external

services to eliminate barriers to health care

Freeman HP. Oncol Issues. 2004;5:44-46.

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Goals of a Patient Navigation ProgramGoals of a Patient Navigation Program

The main goals of patient navigation are:– To save lives from cancer– To eliminate barriers to care– To ensure timely delivery of services

Freeman HP. Oncol Issues. 2004;5:44-46.

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Potential Barriers toReceiving Timely Health CarePotential Barriers toReceiving Timely Health Care

Barriers interfere with appropriate and timely care– Delays of 3 to 6 months in initiating breast cancer treatment

were associated with lower survival rates– Strong connection found between African American race and

delay in breast cancer screening and treatment

Patient navigation originally targeted the poor who:– Endure greater pain and suffering than other Americans– Feel cancer education and outreach efforts are irrelevant to

them

Elderly experience discrimination– Health care professionals may have limited training in geriatrics– Less likely to receive preventive care or screening

Freeman HP, et al. Cancer Pract. 1995;3:19-30. Richards MA, et al. Lancet. 1999;353:1119-1126.Sheinfeld Gorin SN, et al. Presented at: 41st Annual meeting of the ASCO; May 13-17, 2005; Orlando, Fla.Alliance for Aging Research. Washington, DC; 2003.

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Potential Barriers toReceiving Timely Health Care (cont’d)Potential Barriers toReceiving Timely Health Care (cont’d)

Freeman HP, Reuben SH. Voices of a Broken System. Bethesda, Md: NIH, NCI; 2001.

Financial and economic Lack of or inadequate insurance

Transportation Difficulty arranging transportation

Cultural Cultural beliefs regarding treatment

Communication and language Difficulty telling desires/needs

Health care system Fragmentation of care

Bias based on race/age Fear and mistrust by patients; inadequate screening of the elderly

Fear Delay or refusal of care

ExamplesExamplesBarrierBarrier

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Patient Navigation’s Guiding PrinciplesPatient Navigation’s Guiding Principles

Ensure that quality, confidentiality, and professionalism are threaded throughout all aspects of care and programming. Inherent in patient navigation is continuous quality care for patients from screening through diagnosis and treatment, based on the following tenets:– Culturally competent care– Confidentiality– Respect– Compassion– Patient safety

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The Patient Navigation ModelThe Patient Navigation Model

The Cancer Care Continuum

Freeman HP, et al. Cancer Pract. 1995;3:19-30.

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Suitable for Many Health Care SettingsSuitable for Many Health Care Settings

The navigation program:

– Is adaptable to different settings and needs

– Encourages compassion toward persons who are being served

– Defines at what point a navigator is engaged and what a navigator does

– Respects the confidentiality of the patients involved

– Is reliable so that patients and navigators in the program can trust the information and help received

– Evaluates the effectiveness of the program

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Responsibilities of a NavigatorResponsibilities of a Navigator

Meet with patients at point of suspicious finding

Identify any barriers or potential barriers to care

Streamline appointments and paperwork

Maintain open communication with health care providers, caregivers, and patients

Assist in increasing access to culturally appropriate, supportive care when and where possible

Link patients, caregivers, and families with appropriatefollow-up services

Maintain personal contact with patients throughout the health care continuum and follow their progress

HANYS BCDP®. Breast Health Patient Navigator Program Resource Kit. Rensselaer, NY: HANYS; 2002.

Long Island College Hospital. Breast Health Navigator Program. Rensselaer, NY: HANYS; 2002.

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Characteristics of a NavigatorCharacteristics of a Navigator

Preferably selected from the community of patients being served

Compassionate with a sincere desire to help people

Understands the issues of financial, cultural, educational, and social barriers to information and care in the patient community

Can communicate effectively with patients, their families, and health care providers

Is organized and can demonstrate creative problem-solving solutions

Is highly resourceful and able to research resources for patients

Freeman HP. Oncol Issues. 2004;5:44-46.

Long Island College Hospital. Breast Health Navigator Program. Rensselaer, NY: HANYS; 2002.

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Possible Benefits of Patient Navigation ProgramsPossible Benefits of Patient Navigation Programs

Improved coordination of high-quality care

Enhanced access to services for all populations

Removal of barriers to care

More efficient delivery of care

Improved outcomes

Improved sharing of resources

Enhanced relationships with the community

Increased patient satisfaction

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ConclusionConclusion

Patient navigation eliminates barriers to enable individuals with a suspicious finding to receive timely diagnosis and treatment

Patient navigation keeps patients from falling through the cracks

Patient navigation programs exist across the United Statesand Canada

US legislation signed into law in support of patient navigation programs

Patient navigation can be of great benefit to [Name of our organization]