TM Introduction to Patient Navigation 1

2 TM 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.

3 TM Goals 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.

4 TM Potential Barriers to Receiving 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: Richards MA, et al. Lancet. 1999;353: 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.

5 TM Potential Barriers to Receiving Timely Health Care (cont’d) Freeman HP, Reuben SH. Voices of a Broken System. Bethesda, Md: NIH, NCI; Financial and economicLack of or inadequate insurance TransportationDifficulty arranging transportation CulturalCultural beliefs regarding treatment Communication and languageDifficulty telling desires/needs Health care systemFragmentation of care Bias based on race/age Fear and mistrust by patients; inadequate screening of the elderly FearDelay or refusal of care Examples Barrier

6 TM Patient 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

7 TM The Patient Navigation Model The Cancer Care Continuum Freeman HP, et al. Cancer Pract. 1995;3:19-30.

8 TM Suitable 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

9 TM Responsibilities 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 appropriate follow-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; Long Island College Hospital. Breast Health Navigator Program. Rensselaer, NY: HANYS; 2002.

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

11 TM Possible 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

12 TM Conclusion 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 States and Canada US legislation signed into law in support of patient navigation programs Patient navigation can be of great benefit to [Name of our organization]