Background: Patient navigators (PNs) have become valued members of the cancer multidisciplinary team as they help patients work their way through diagnosis and treatment, and into survivorship. Our PN model was developed based on 2 important criteria: (1) our effective clinical research nurse model; and (2) the identified needs of our diverse patient population. Boston Medical Center’s PN program involves multiple departments: medical oncology, urology, otolaryngology, breast health, and primary care. Since the development of our program, the PN role has expanded to include patient education, which complements education by the clinical team. Standard operating procedures and disease algorithms are in place to standardize and train new navigators and to provide consistent exceptional care.
Methods: By attending the multidisciplinary patient conferences, support groups, and other survivorship activities, PNs are very knowledgeable regarding treatment plans, barriers to care, and the benefits of support groups and alternative treatments for the patient with cancer. Patient education is considered to be part of a team approach and goes beyond diagnosis and treatment; it involves assisting and empowering patients to identify and use available resources. Transportation is one of our largest patient needs, with more than 5000 rides provided during 2010. Assisting patients with their transportation needs reinforces the importance of adhering to treatment schedules and follow-up appointments and provides the tools for patients to work toward scheduling their own transportation. Introducing patients to other support services and resources provides a comprehensive care plan which improves patient satisfaction, decreases the no-show rate, and increases treatment compliance. Services and resources include clinical trials staff; support groups; our Medical Legal Partnership Program; social work services; the food pantry; alternative treatments such as massage, acupuncture, and meditation; spiritual care; and American Cancer Society onsite representatives.
Results and Conclusions: Patients who are part of the PN program show an average “no-show” rate of ~4% compared with patients not in the PN program who have a “no-show” rate of ~13%. In addition, since the inception of the PN program, ~11% of navigated patients have participated in a clinical trial, with 75% being of a minority population. In conjunction with other staff, a patient’s educational needs are assessed on a continuous basis and remain a top priority to determine effective coping strategies, resources, and support to a diverse patient population who typically deal with multiple life challenges. Close to 100% of patients in the PN program reported a positive experience and found the overall relationship with their PN very educational and empowering as they cope with their current disease and prepare for life as a survivor.
