The CATCH: In Support of Patient Advocacy

Cynthia Shechter

Patient feedback, questions, symptoms, and concerns should help lead healthcare professionals in patient care and care planning.

—Cynthia Shechter

A CATCH is a navigation success story where a navigation tactic improved a patient’s situation. The CATCH Initiative, short for Catching & Addressing Threats to Care & Health, tracks and acknowledges positive outcomes of navigation tactics.

The CATCH of the Month

Background: A patient with a stage IV breast cancer diagnosis with lung and brain metastases and virtually no outside support needed a healthcare proxy. Navigator Cynthia Shechter was asked to serve as the patient’s proxy.

The Incident: The patient was admitted to a skilled nursing facility. Her condition was deteriorating, and she was experiencing seizures and bleeding brain lesions. Physical therapy was placed on a hold due to the patient’s dizziness, low endurance, and orthostatic hypotension. Cynthia expressed concern for the hold due to the potential for blood clots and deconditioning, which were overlooked by medical staff. The patient ultimately expressed concern about new-onset swelling and redness in her legs accompanied by a cough. The treating physician dismissed the patient’s concerns without appropriate follow-up. Recognizing the severity of the patient’s stated symptoms, the navigator emphatically requested a doppler and chest x-ray. The tests revealed several pulmonary embolisms and a coronary thrombosis.

The CATCH (Intervention): There was miscommunication among various medical specialists about the patient’s wishes, including unmanaged pain and wishing to die at home. Cynthia was able to speak on the patient’s behalf to ensure her concerns and final wishes were acknowledged and honored.

Outcome: Being the patient’s advocate, Cynthia was able to catch a life-threatening medical condition, ensure proper pain management, and secure appropriate hospice care, which led to an improvement in quality of life. This navigator’s advocacy allowed the patient to die with dignity at home as she wished.

The Importance of the CATCH

The role of navigators in advocacy and patient empowerment was addressed in a case study by Cheryl Bellomo and colleagues¹ as follows: “Navigators empower patients by ensuring they know their options, identifying their preferences and priorities, providing patients with strategies to cope with their disease, treatment, and stress, and assisting them to access healthcare services.”

This CATCH validates the importance of navigation and the impact a navigator can have on a patient’s cancer journey even as the patient reaches the end of life. This navigator not only advocated for the patient medically, but also fought for her voice to be heard and final wishes to be honored.

Reference

1. Bellomo C, Christensen D, Strusowski T. Seasoned navigator: a case study on patient advocacy/patient empowerment. Journal of Oncology Navigation & Survivorship. 2016;7(8):31-32.

More on End-of-Life Care

Facing the End of Life: How Navigators Can Ease the Burden for Patients and Loved Ones