The Three Cs of Patient Navigation

Laurie DeRuosi, MSN, FNP-BC, CBE-C, CN-BP

If you were diagnosed with cancer or a chronic, debilitating disease, who would you turn to for help? How would you address the uncertainties associated with your new diagnosis? The answer is simple. You need not look any further than a patient navigator. These trained medical professionals are part of the medical team, offering comfort, consistency and care to patients.

What is a patient navigator?

A patient navigator is someone who provides personal guidance and support to patients as they move through the health care system. They provide one-on-one assistance to individuals as they journey from screening, diagnosis, treatment and completion of care. Moreover, the navigator provides advocacy, education, and consistency throughout the health care continuum.

The idea for patient navigators came from Dr. Harold Freeman in 1990 while working at Harlem Hospital in New York. He was the first to identify disparities in health care access for different populations, which led to poor outcomes in his patients with advanced cancers. He determined the need to “navigate” patients from the point of identifying cancer through their treatment to improve their outcomes. Dr. Freeman worked tirelessly to eliminate barriers to timely cancer screening, treatment and supportive care, and successfully established the first navigation program in the country.

Who can serve?

Patient navigators come from a variety of backgrounds and may have professional medical, legal, financial, or administrative experience. In breast health care, navigators can seek certification training and validation of their expertise through programs offered by the National Consortium of Breast Centers, Inc. (NCBC). Certifications are offered for a number of positions, including breast imagers, managers/social workers, advocates, clinical assistants/vocational nurses, nurses and providers.

What is the purpose of having a breast center patient navigator?

Breast cancer is one of the areas where patient navigators are key to improved outcomes. It’s estimated that one in eight American women will develop breast cancer in their lifetime. Women with newly diagnosed breast cancer face a variety of challenges, stressors, and fears. They’re often overwhelmed, not only with the diagnosis of breast cancer, but also the amount of information about their diagnosis and its treatment. In many cases, women are left with more questions than answers, which presents a unique opportunity for early intervention.

The breast care navigator is often the first point of contact for newly diagnosed patients, offering reassurance and direction during a very uncertain time. In addition to offering emotional support and guidance, their role is to eliminate any and all barriers to care while promoting a smooth, timely transition between phases of treatment.

These can include psychosocial hurdles like fear, distrust, or cultural differences. Communication problems, including a lack of understanding or language barriers, issues with medical systems, financial or insurance barriers, and logistical obstacles like transportation or childcare can also interfere with treatment and healing.

The breast care navigator strengthens care coordination and facilitates communication between providers to prevent treatment delays while offering emotional support for the patient. The navigator also monitors and manages symptoms. They can even identify and recommend additional services.

What are the benefits to patients?

Studies have shown the numerous benefits of patient navigation programs, including:

  • Greater patient satisfaction
  • Lower levels of stress, depression and anxiety
  • Improved quality of life
  • A source of comfort, consistency, and improved patient outcomes

Patient navigation programs are a requirement for all cancer centers seeking approval from the American College of Surgeons (ACoS) Commission on Cancer. The Lifespan Cancer Institute has received this accolade and offers patient navigation programs throughout our system, including for breast cancer.