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MODULE4: 

Resources
THEBASICSOFPATIENTNAVIGATION


Lesson1:TheRoleofthePatientNavigator

LearningObjectives
x Describetheroleofthepatientnavigator
x Compareandcontrastrolesacrosspatientnavigatortypes

KeyTakeaways
x Allnavigatorsaddressbarrierstocare.
x Barrierstocaremaybepractical,personal,systemsbased,providerbasedor
psychosocial.

 

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GeorgeWashingtonUniversity(GW)CancerInstitute2015
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LESSON1:THEROLEOFTHEPATIENT
NAVIGATOR

ThePatientNavigatorsRole
SamplePatientNavigatorJobDescription
PossibleBarriers
PatientNavigatorDuties
DayintheLifeofaPatientNavigator
ResourcesforPatientNavigators


ThePatientNavigatorsRole
Patientnavigatordutiesvary,butthemainrolethatallhaveincommonisaddressingbarrierstocare.The
patientnavigatorhelpspatientsidentifyandovercomechallengestogettingmedicalcare.Sometimesthe
navigatordirectlyremovesbarriersforpatients,butoftenthenavigatorhelpsthepatientsremovebarriers
themselves.Therearesomegeneralfunctionalcategoriesthatdescribepatientnavigatorfunctions:
x ProfessionalRolesandResponsibilities x EthicsandProfessionalConduct
x BarrierstoCare/HealthDisparities x CulturalCompetency
x PatientEmpowerment x Outreach
x Communication x CareCoordination
x CommunityResources x PsychosocialSupportServices/Assessment
x Education,PreventionandHealth x Advocacy
Promotion

Source:Willisetal.2013.

Allpatientnavigatorsaddressbarrierstocare,nomatterwheretheyworkinthecancercontinuum:

Survivorship:
Referrals for
Treatment:
wellness/nutrition;
Primary Education,
Screening/Early stress
Prevention: Support,
Detection:Remove management;
Adoptionof coordinationof
barrierstoaccess education;
healthylifestyle, multidisciplinary
toscreening survivorshipcare
diseaseprevention care,resource
plans;support
referrals
groups,retreats
andotherservices


Onthenextpageyouwillfindasamplepatientnavigatorjobdescription,whichisalsoavailableinthe
learningmanagementsystem.

OncologyPatientNavigatorTraining:TheFundamentals
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POSITIONDESCRIPTION:PATIENTNAVIGATOR

BASICFUNCTION
ThePatientNavigatorworksinadynamichealthcareenvironmentwithinoneormoredepartmentsproviding
oneononeassistancetopatients,navigatingthemthroughthehealthcaresystemtoensuretimely
screening,diagnosis,treatmentand/orposttreatmentcancercareandsupportiveservices.S/heworkswith
otherhealthcareprofessionalstoestablishandmaintainaclimateofmutualrespect,dignity,diversity,ethical
integrityandtrustandparticipatesinmultidisciplinaryteamstoprovidepatientcarethatissafe,timely,
efficient,effectiveandequitable.S/heusesknowledgeofone'sroleandtherolesofotherhealthcare
professionalstoappropriatelyassessandaddresstheneedsofpatientsservedtooptimizehealthand
wellness.S/heisexpectedtosetlearningandimprovementgoals;identifyandperformlearningactivitiesthat
addressone'sgapsinknowledge,skills,attitudesandabilities;andrespondtofeedbacktoimprove
professionalperformanceandpatientcare.

CHARACTERISTICDUTIES
Assistpatientsinaccessingcancercareandnavigatinghealthcaresystems.
Assessbarrierstocareandengagepatientsandfamiliesincreatingpotentialsolutionstofinancial,
practicalandsocialchallenges.
Identifyappropriateandcredibleresourcesresponsivetopatientneeds(practical,social,physical,
emotional,spiritual),takingintoconsiderationreadinglevel,healthliteracy,culture,languageandamount
ofinformationdesired.Refertolicensedcliniciansforphysicalconcerns,emotionalneedsorclinical
education.
Educatepatientsandcaregiversonthemultidisciplinarynatureofcancertreatment,therolesofteam
membersandwhattoexpectfromthehealthcaresystem.Providepatientsandcaregiversevidencebased
informationandrefertoclinicalstafftoanswerquestionsaboutclinicalinformation,treatmentchoices
andpotentialoutcomes.
Empowerpatientstocommunicatetheirpreferencesandprioritiesfortreatmenttotheirhealthcare
team;facilitateshareddecisionmakinginthepatient'shealthcare.
Empowerpatientstoparticipateintheirwellnessbyprovidingselfmanagementandhealthpromotion
resourcesandreferrals.
Followupwithpatientstosupportadherencetoagreedupontreatmentplanthroughcontinuednon
clinicalbarrierassessmentandreferralstosupportiveresourcesincollaborationwiththeclinicalteam.
Contributetopatientnavigationprogramdevelopment,implementationandevaluation.
Assesspatientcapacitytoselfadvocate;Helppatientsoptimizetimewiththeirdoctorsandtreatment
team(e.g.prioritizequestions,clarifyinformationwithtreatmentteam).
Encourageactivecommunicationbetweenpatients/familiesandhealthcareproviderstooptimizepatient
outcomes.

RELATEDDUTIES
Performsspecialprojectassignmentsrequiredtosupporttheimplementationandevaluationofpatient
navigation.
Assistswithcarecoordinationofpatients.
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Enhancesprofessionalknowledge/skillsbyidentifyingandparticipatingincontinuingeducation
opportunities.
Performsothernonclinicalworkrelateddutiesasrequested.

SUPERVISIONRECEIVED

Supervisionisreceivedfrom____________.

QUALIFICATIONSANDSKILLSREQUIRED
Basicunderstandingofmedicalterminology,healthcaresystemsandhealthcarefinancingrequired.
Proficiencywithapersonalcomputerisnecessary.DemonstratedfluencyinEnglish/[Insertanylanguage
requirementshere].Inaddition,thepatientnavigatormustbeableto:
Workcooperativelyandcommunicateeffectivelywithawiderangeofindividuals,includingpatientsand
familymembersfromdiversesocioeconomicandculturalbackgrounds,healthcareprofessionalcolleagues
andexternalhealthandservicefocusedorganizations.
Employactivelisteningandremainsolutionsorientedininteractionswithpatients,familiesandmembers
ofthehealthcareteam.
Demonstrateempathy,integrity,honestyandcompassionindifficultconversations.
Applyinsightandunderstandingaboutemotionsandhumanresponsestoemotionstocreateand
maintainpositiveinterpersonalinteractions.
Applyknowledgeofthedifferenceinrolesbetweenclinicallylicensedandnonlicensedprofessionalsand
actwithinprofessionalboundaries.Excellentcommunication,organizational,andinterpersonalskillsare
necessary.

WORKINGCONDITIONS
Theincumbentperformsjobdutiesinanormalbusinessofficeenvironmentand/orinacommunitybased
settingexteriortothenormalbusinessofficeenvironment.Tasksaregenerallycarriedoutinasedentary
formatwithinthebusinessenvironment.Thisinvolvesworkingwhilesittingatadeskforextendedperiodsof
time;exteriorworkingenvironmentsrequirestandingand/orwalkingforextendedperiodsoftime.Typically,
theincumbentwillnotbeexposedtoadverseweatherconditionsorphysicalactivitiesinordertoperformthe
jobotherthanoccasionallyliftingofficesupplyitemsthatmayweighupto20pounds.Theincumbentwillbe
requiredtoattendmeetingsinotheroffices,ordeliverand/orretrieveinformationfromotherofficesaround
campusandwithincommunitybasedsettings.


 

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PossibleBarriers

Therearegenerallyfivetypesofbarrierstocarethatyoumayneedtoassistwith:

Practical
Treatmentcosts
Transportation
Languagebarriers
Work
Foodinsecurity
Insuranceproblems
Stablehousing
Immigrationstatus
Psychosocial
Anxietyanddepression
Changesinrelationshipsandrolesinfamily
Familyandsocialsupport
Stigma,fear,socialisolation
Mentalhealth
Provider
Biasesinmedicalrecommendations
Poorcommunicationwithpatientswithlowliteracy
PoorcommunicationwithlimitedEnglishproficientpatients
Culturaldissonance
Systems
Lackofinterpreters
Longwaittimes
Lackofappropriateproviders
Inconvenientappointmenttimes
Personal
Lackofknowledge
Healthmyths
Mistrustofproviders
Lowpriorityplacedonhealth

Source:PNTC.
OncologyPatientNavigatorTraining:TheFundamentals
GeorgeWashingtonUniversity(GW)CancerInstitute2015
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MO ODULE4 4: 
Resou
urces
THEBASICSO
OFPATIEENTNAV
VIGATION


PatieentNavigato orDuties

Anottherwayoftthinkingabooutpatientn
navigationdutiesistothhinkaboutw
whatactionsyoutaketohelp
patieents,ortasks,andwhatwaysyouinteractwitthothers,orrhowyounnetwork.

NavigatorTasks

Maintaining
M Doccumenting
Navigating Facilitating O
Other
systems activities
Cooaching Finddingpatients Identifying Charttingtotrack Admin nistrative
Exxplaining Cooordinating entialpatientss
pote navigaation dutiestosupport
Acctivelisteningg team Build
ding activittiesin researcch
commmunication netw
worksand patienntsrecord Filingp
papers
Asskingquestion ns
Inte
egrating referrralroutines orthrrough Collaborating
info
ormation Reviewingcases navigaation withnuurse
thro
ough softw
ware ortools navigattors(if
doccumentation applicaable)
anddsharingwith
h
team
Collaborating


NavigationNetw
workDuties

Patientin
nteractions

Provideriinteractions

Noncliniccalstaff

Supportivveservices

PaperorElectronicMe
edicalRecords

Sourrce:Parkere
etal.2010.

ologyPatientNavigatorTraaining:TheFu
Onco undamentals
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ADayintheLifeofaPatientNavigator

Thetablebelowsummarizesadayinthelifeofapatientnavigatorwhoworkswithbreastcancerpatients.

Barrier/Event Action/NextStep

Callfrompatientwhohassurgeryin2days.Patient Mailpatientinformationoncamisole,includinga
wouldliketospeakwithanesthesiologistabout prescriptionandalistofplacesshecangetit;ask
nerveblock.Patientalsoneedsinformationabout doctortotaskanesthesiologisttocallthepatient
bras/garmentssheshouldwearafterthesurgery. beforetheprocedure.

Newlydiagnosedpatient(olderwoman,came Completedistressscreening,assessbarriersto
alone). care,helppatientidentifysupport;nextstep:BSGI
(refertonursetoexplainprocedure).

Patienthasconcernsabout6monthfollowup Askphysiciantoclarifyscreeningplan with


screeningplangiventoherbydoctor.Sheis patient;supplypatientwithcorrectorderif
supposedtohaveamammogram,butoneofher neededandtellherhowtoscheduleprocedure(s).
cancerswasnotvisibleonmammography.

Patientcallswithquestionsaboutradiation(has Assistpatientwithschedulingappointmentand
notbeeninforherconsultyet). givegeneralinformation.

Newlydiagnosedpatient(mid30s,hasyoung Completedistressscreening,assessbarriersto
children)comesinforfirstappointment. care,helpidentifysupport;assistinfinding
oncologistclosetopatientshome;givebasic
informationaboutbreastcancerand
chemotherapy;refertonursetoexplainMediport
andtestsneededbeforestartingtreatment.

Patientbeginningchemoneedsherdoctortospeak Getdoctorsdirectphonenumber,trackdown
withsurgeonASAPregardingrecommendations. surgeon,askhertocalldoctor.
Otherdoctorisgoingonvacationtomorrow.

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PatientapplyingfordisabilityandMedicaid,needs FaxMedicalExaminationReportformtoPCPs
referraltoinfectiousdisease,psychiatry.Needs office;taskinfectiousdiseaseadministrativestaff
PET/CT. tocallpatientwithappointmenttime;givepatient
numbertoschedulePET/CT;followupon
psychiatryreferral.

Patientplanningmastectomysurgery,wouldliketo Workwithsurgeontoidentifyformerpatient;
speakwithformerpatientwhohadthesame contactformerpatientandaskifshewouldliketo
procedure. participate;contactcurrentpatientwithformer
patientscontactinformation.

Patientlivesfarawayandwouldlikeaconsultwith Assistpatientwithschedulingappointment;call
radiationonthesamedayasherappointmentwith patientbackwithinformation
surgeon.

Referralfrommedicaloncologistforpatienttosee Callpatientandsetuptimetomeetwithdietitian;
dietitian. addpatienttodietitiansschedule.

Patientneedsappointmentwithphysicaltherapist. Discussroleofrehabilitationclinic;schedule
patientappointments.

 

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ResourcesforPatientNavigators

x AcademyofOncologyNurseandPatientNavigators(AONN+)
AONN+isthelargestprofessionalsocietyforoncologynurseandpatientnavigators.
x AssociationofCommunityCancerCenters(ACCC)PatientNavigationTools
ThissectionoftheACCCwebsiteoffersaprogrampreassessmenttool,descriptionofpatient
navigatorresponsibilitiesandcorefunctions,samplejobdescriptions,sampleprogrampoliciesand
standardoperatingprocedures(SOPs),sampleassessmentandtrackingforms,samplepatient
satisfactionsurveysandanoutcomesmeasuretool.
x CChangesCancerPatientNavigationOverview
Thiswebsiteincludesinformationtopromotepatientnavigationandthedevelopmentofcommunity
basedpatientnavigationprograms.
x KansasCancerPartnershipsCancerPatientNavigationProgramToolkit
Thisguideprovidesavarietyofpatientnavigatortools,includingasamplepatientnavigatorposition
description,sampleintakeformsandtrackingtools,sampleflyers,asamplepatientsatisfactionsurvey
andmore.
x TheBostonMedicalCenterPatientNavigationToolkit
Thistoolkitprovidestoolsfordeterminingyournavigationtasks,sampleinterviewquestions,patient
navigatorintroductiontips,patientnavigatorprotocolsandotherusefultools.
x WillisA,PrattChapmanM,ReedE,HatcherE.BestPracticesinPatientNavigationandCancer
Survivorship:MovingTowardQualityPatientCenteredCare.JournalofOncologyNavigationand
Survivorship.2014.
x WillisA,Reed,PrattChapmanM,KappH,HatcherE,VaitonesV,CollinsS,BiresJ,WashingtonEC.
DevelopmentofaFrameworkforPatientNavigation:DelineatingRolesAcrossNavigatorTypes.Journal
ofOncologyNavigationandSurvivorship.2013.
 

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Module4,Lesson1:TheRoleoftheOncologyPatientNavigator
References:Presentations
AgencyforHealthcareResearchandQuality.CareCoordinationMeasuresAtlas:Chapter2:WhatisCare
Coordination.2014.Retrievedfrom:http://www.ahrq.gov/professionals/preventionchronic
care/improve/coordination/atlas2014/chapter2.html.
BoneLR,EdingtonK,RosenbergJ,etal.Buildinganavigationsystemtoreducecancerdisparitiesamongurban
blackolderadults.ProgCommunityHealthPartnership.2013;7(2):209218.doi:10.1353/cpr.2013.0018.
CommunityToolbox.Chapter23:ModifyingAccess,Barriers,andOpportunities.Section6:UsingOutreachto
IncreaseAccess.2014.Retrievedfrom:http://ctb.ku.edu/en/tableofcontents/implement/accessbarriers
opportunities/outreachtoincreaseaccess/main.
FioreMC,BaileyWC,CohenSJ,etal.TreatingTobaccoUseandDependence.ClinicalPracticeGuideline.
Rockville,MD:U.S.DepartmentofHealthandHumanServices.PublicHealthService.June2000.
HopkinsJ,MumberMP.Patientnavigationthroughthecancercarecontinuum:Anoverview.JOncolPract.
2009;5(4):150152.doi:10.1200/JOP.0943501.
JohnsHopkinsSchoolofNursing.Communityoutreachprogram.n.d.Retrievedfrom:
http://nursing.jhu.edu/excellence/community/outreach.html.
NationalCancerInstitute.Cancerhealthdisparitiesfactsheet.2008.Retrievedfrom:
http://www.cancer.gov/aboutnci/organization/crchd/cancerhealthdisparitiesfactsheet.
ParkerVA,ClarkJA,LeysonJ,etal.Patientnavigation:Developmentofaprotocolfordescribingwhat
navigatorsdo.HealthServRes.2010;45(2):514531.doi:10.1111/j.14756773.2009.01079.x.
PatientNavigatorTrainingCollaborative.n.d.Retrievedfrom:http://patientnavigatortraining.org/.
TheOfficeofMinorityHealth.WhatisCulturalCompetency.2013.Retrievedfrom:
http://minorityhealth.hhs.gov/omh/browse.aspx?lvl=1&lvlid=6.
WillisA,ReedE,PrattChapmanM,etal.Developmentofaframeworkforpatientnavigation:Delineating
rolesacrossnavigatortypes.JournalofOncologyNavigation&Survivorship.2013;4(6):2026.
References:BriefQuiz
BraunKL,KagawaSingerM,HoldenAE,etal.Cancerpatientnavigatortasksacrossthecancercare
continuum.JHealthCarePoorUnderserved.2012;23(1):398413.doi:10.1353/hpu.2012.0029.
ParkerVA,ClarkJA,LeysonJ,etal.Patientnavigation:Developmentofaprotocolfordescribingwhat
navigatorsdo.HealthServRes.2010;45(2):514531.doi:10.1111/j.14756773.2009.01079.x.
PrattChapmanM,WillisA,MasselinkL.Corecompetenciesforoncologypatientnavigators.Journalof
OncologyNavigationandSurvivorship.April2015.
VargasRB,RyanGW,JacksonCA,RodriguezR,FreemanHP.Characteristicsoftheoriginalpatientnavigation
programstoreducedisparitiesinthediagnosisandtreatmentofbreastcancer.Cancer.2008;113(2):426433.
doi:10.1002/cncr.23547.
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WillisA,ReedE,PrattChapmanM,etal.Developmentofaframeworkforpatientnavigation:Delineating
rolesacrossnavigatortypes.JournalofOncologyNavigation&Survivorship.2013;4(6):2026.


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