The working definition of patient navigation was provided by the NCI’s CRHCD in their request for applications. 13 In this definition, patient navigation refers to support and guidance offered to persons with abnormal cancer screening or a new cancer diagnosis in accessing the cancer care system, overcoming barriers, and facilitating timely, quality care provided in a culturally sensitive manner. Patient navigation is intended to target those who are most at risk for delays in care, including racial and ethnic minorities and those from low income populations. Furthermore, patient navigation targets specific time points in the cancer care continuum; we operationally define patient navigation as starting at the time of an abnormal screening result and ending at the determination that the screening test was a false positive or, for those individuals with a new cancer diagnosis, continuing through the completion of cancer treatment. The goal of patient navigation is to facilitate timely access to quality cancer care that meets cultural needs and standards of care for all patients.
Examples of navigation services include: arranging various forms of financial support, arranging for transportation to and childcare during scheduled appointments, identifying and scheduling appointments with culturally sensitive caregivers, coordinating care among providers, arranging for interpreter services, ensuring coordination of services among medical personnel, ensuring that medical records are available at each scheduled appointment, and providing other services to overcome access barriers encountered during the cancer care process including linkage to community resources. Navigators work to address health literacy and to train patients to advocate for themselves in the health care system. They are also trained to provide emotional support to patients during this stressful period. Navigators may also identify systems issues that serve as barriers to many patients, and work towards reduce the complexity to the patient of the multidisciplinary approach to care.
The concept of patient navigation is based upon the care management or case management model, which has four components.14 The first is case identification, which is a systematic approach to the identification of those individuals with abnormal cancer screening in need of follow-up care or incident cancers. The second is identifying individual barriers to receiving care. Navigators contact patients and elicit information about the barriers to completion of recommended care. The third is developing an individualized plan to address the barriers that are identified. The fourth is tracking, which is a systematic method of following each case through resolution of the problem. In the case of cancer navigation, this is to resolution of a diagnostic evaluation when a benign condition is diagnosed or follow-up to completion of primary therapy when a cancer or pre-malignant condition is diagnosed.
The navigator will focus on assisting patients and coordinating care of the patients among providers, community, and the patients and their families. Given that patient navigators are working primarily with racial/ethnic minority and low-income patients, cultural competence is a key feature. Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that enable effective work in cross-cultural situations.15
PNRP sites vary in the prior training, skill sets, and educational background of navigators and include lay community peers, health educators and advocates, medical assistants, social workers, and nurses. The study has set a minimum requirement of a high school diploma or General Education Diploma. In an effort to achieve a core set of knowledge, skills, and competencies across navigators, a standardized training has been developed. The curriculum focuses on basic information about cancer and its diagnosis and treatment, professionalism, understanding barriers to care, communication skills, cultural competency, ethical conduct of human subjects research, and developing a local network of resources to support patients.16
Examples of navigation services include: arranging various forms of financial support, arranging for transportation to and childcare during scheduled appointments, identifying and scheduling appointments with culturally sensitive caregivers, coordinating care among providers, arranging for interpreter services, ensuring coordination of services among medical personnel, ensuring that medical records are available at each scheduled appointment, and providing other services to overcome access barriers encountered during the cancer care process including linkage to community resources. Navigators work to address health literacy and to train patients to advocate for themselves in the health care system. They are also trained to provide emotional support to patients during this stressful period. Navigators may also identify systems issues that serve as barriers to many patients, and work towards reduce the complexity to the patient of the multidisciplinary approach to care.
The concept of patient navigation is based upon the care management or case management model, which has four components.14 The first is case identification, which is a systematic approach to the identification of those individuals with abnormal cancer screening in need of follow-up care or incident cancers. The second is identifying individual barriers to receiving care. Navigators contact patients and elicit information about the barriers to completion of recommended care. The third is developing an individualized plan to address the barriers that are identified. The fourth is tracking, which is a systematic method of following each case through resolution of the problem. In the case of cancer navigation, this is to resolution of a diagnostic evaluation when a benign condition is diagnosed or follow-up to completion of primary therapy when a cancer or pre-malignant condition is diagnosed.
The navigator will focus on assisting patients and coordinating care of the patients among providers, community, and the patients and their families. Given that patient navigators are working primarily with racial/ethnic minority and low-income patients, cultural competence is a key feature. Cultural and linguistic competence is a set of congruent behaviors, attitudes, and policies that enable effective work in cross-cultural situations.15
PNRP sites vary in the prior training, skill sets, and educational background of navigators and include lay community peers, health educators and advocates, medical assistants, social workers, and nurses. The study has set a minimum requirement of a high school diploma or General Education Diploma. In an effort to achieve a core set of knowledge, skills, and competencies across navigators, a standardized training has been developed. The curriculum focuses on basic information about cancer and its diagnosis and treatment, professionalism, understanding barriers to care, communication skills, cultural competency, ethical conduct of human subjects research, and developing a local network of resources to support patients.16
