Patient Navigation

Introduction

Evidence-based interventions are strategies that are proven to work. The Community Preventive Services Task Force recommends several interventions to increase screening for breast, cervical, and colorectal cancers. They include actions designed to reach patients and actions designed to reach health care providers.

Evidence suggests that combining two or more strategies increases community demand for and access to cancer screening and lowers costs. Strategies should be added to your clinic's daily work process in ways that ensure they will last over time and work well for different cancer programs.

The Community Preventive Services Task Force recommends patient navigation for breast, cervical, and colorectal cancer screening.

Overview

Patient navigators work with people, their families, and their caregivers to overcome barriers to cancer screening and diagnosis, cancer care, and resources needed after cancer treatment.

Patient barriers may include:

• Lack of transportation.
• Lack of care for children or elderly relatives.
• Not understanding why they should get screened.
• Speaking a language other than English.
• Mistrust of the health care system.
• Fear of finding out they have cancer or fear of the screening procedures.

How to create a patient navigation system

• Identify internal and external partners—like clinics or community-based organizations—to work with.
• Determine the type of patient navigator you need—for example, a social worker, community health worker, or nurse.
• Develop a process to monitor the system and track screenings and outcomes. Identify what data will be needed.
• Use the Patient Navigation Barriers and Outcomes Tool developed by George Washington University as a guide.

Questions to ask

• Who will supervise your patient navigators?
• How will navigation be delivered—for example, in person, electronically, or by telephone?
• Where will patient navigators be located—for example, within your health system or clinic or at a partner's location?

How to support a patient navigation system

Identify the resources you'll need

• To hire, train, and supervise the patient navigators.
• To provide technology to the navigators.
• To make sure patients receive high-quality support.

Look for ways to reduce costs

• Look for grants from the federal government, private foundations, state health departments, philanthropic organizations, academic institutions, and medical societies.
• Share costs with other programs in your organization or other clinics that use navigators.

Remember that the money saved by reducing the number of patients who cancel appointments at the last minute, or don't show up, may offset the cost of the new system. For more ideas, see the Paying for Colorectal Cancer Screening Patient Navigation Toolkit and Interactive Website.

Success stories

Community health workers help women in Nevada get screened for breast and cervical cancer

Nevada's breast and cervical cancer screening program hired community health workers to help women with low incomes get screened and use other health care services. The community health workers work with patients to find out what help they need to get screening or other health care. Read Nevada's story.

Navigators help patients get screened for cancer in Pennsylvania

Pennsylvania's HealthyWoman Program trained and paid for two patient navigators. The navigators worked with two local health organizations to reach out to Latino and African populations. Read Pennsylvania's story.