Background: Oncology nurse navigators have many clinical and nonclinical responsibilities. Lay patient navigators are trained volunteer community members who can help patients with cancer overcome more of the nonclinical barriers to care. Patient lay navigators can provide peer and emotional support to patients diagnosed with cancer. In addition, they can address nonclinical barriers to care, educate on existing cancer support resources, and communicate in a supportive manner. According to Lee and Suh, most patient lay navigators are cancer survivors or caregivers of cancer survivors who may positively influence the patient experience.
Objective: The project aimed to implement patient lay navigators as a cost-effective strategy to increase access to peer and emotional support for cancer patients during their continuum of care and offer additional support to increase patient experience and reduce clinical navigation workload.
Methods: A quality improvement project was conducted to implement a patient lay navigation program at 1 site of a healthcare system in 2019. The project was implemented as a collaborative effort between the organization’s cancer services, campus volunteer services, and CanCare. The program utilized nonclinical volunteers to offer additional support to cancer patients and later expanded to include an additional location in 2021. The project team developed a program to train and assign volunteer patient lay navigators to cancer patients and clinical navigators. Patient lay navigators training included orientation with the organization’s volunteer services, CanCare, and the oncology service line. In addition, volunteers were required to complete 20 hours of online lay navigator training that the George Washington Cancer Institute provided. Processes were developed for oncology nurse navigators to identify patients in need of emotional peer support and assign them to lay navigators. The lay navigator would report support needs and follow-up items to the clinical navigation team on completion of patient interactions.
Results: The patient lay navigation program served 321 patients from April to June 2021. During these interactions, patient needs identified included emotional, educational, financial, housing, transportation, physical, spiritual, treatment questions, and other needs. The greatest needs identified were educational needs, which affected ~50% of the patients. Emotional needs were identified in ~33% of patients, and spiritual needs in ~20%. Financial and transportation needs were equally identified in 10% of the patients. The patient lay navigation program interactions resulted in 61 escalated clinical navigation support interventions for cancer patients.
Conclusion: The patient lay navigator program received positive feedback from patients, physicians, and oncology nurse navigators. This program enabled nurses to provide patients with more support in real time and assist in identifying any additional needs that may result in a follow-up from the clinical navigators. The patient lay navigation program was a cost-effective strategy that provided nonclinical support to improve the quality of care and patient experience. Additional support through the program allowed a reduction in nonclinical workloads of oncology nurse navigators and allowed clinical navigators to focus more on patients’ clinical needs. Due to the successful reception of the program in the first 2 locations, the program will expand to other locations in the healthcare system.
Fleisher L, Miller SM, Crookes D, et al. Implementation of a theory-based, non-clinical patient navigator program to address barriers in an urban cancer center setting. J Oncol Navig Surviv. 2012;3:14-23.
Lee MK, Suh SR. Effects of peer-led interventions for patients with cancer: a meta-analysis. Oncol Nurs Forum. 2018;45:217-236.
Sheryl R. The role of patient navigation in improving the value of oncology care. www.hmpgloballearningnetwork.com/site/jcp/article/role-patient-navigation-improving-value-oncology-care. 2016.
The GW Cancer Institute. Patient Lay Navigator program. https://cme.smhs.gwu.edu/gw-cancer-center-/group/gw-cancer-center.