Editor in Chief, Journal of Oncology Navigation & Survivorship®
Patient navigation is a health delivery support strategy that addresses barriers to care and helps explain the maze of information by enhancing patient shared decision-making through culturally appropriate education.
A nurse navigator is like a thread in a garment. This professional makes the care process seamless as they work between the patient and among the many healthcare resources they may have to deal with: people, agencies, or education. The patient is carried by this tapestry through the care continuum to be supported and to make personalized informed decisions. This custom garment envelops any barriers—systemic or patient-related, caregivers who are traveling with the patient, and other disease nuances—to allow for timely and supportive care.
Oncology patient navigators can be:
Regardless, nurse navigators use clinical skills to improve efficiency and adherence to care by ensuring that individualized care is coordinated among members of the team.
The role of nurses in patient navigation evolved from hospital-based utilization review and utilization management to case management, or working directly with healthcare teams caring for specific patient populations. Then, as case managers stayed in-house, nurse navigators followed the shift to outpatient oncology care in the early 2000s. Given the complexity of cancer care and challenges to obtaining care, the nurse navigator is the crucial eyes on the patient from the access point of care through delivery of care and then discharged into follow-up and survivorship care.
The nurse navigator’s view through the eyes of the patient and the analysis of the patient flow from point of system entry, such as screening, to survivorship or end-of-life care. This sets this role apart from an oncology nurse. The nurse navigator has operational management knowledge that tracks patients along the continuum, records steps to reduce barriers, ensures that cancer care meets standards of care such as National Comprehensive Cancer Network guidelines, and documents overall improvements in efficiency for the patient as well as the healthcare system in which they are employed.
An oncology nurse often works in a silo—chemotherapy infusion, oncology in-patient unit, radiation, or other select roles. The nurse navigator provides a holistic approach to care delivery and focuses on care coordination, education, and physical, social, and emotional aspects of care. This all-encompassing eye of the nurse navigator views the entire community, healthcare systems, and provider organizations from the patient’s perspective.
Nurse navigators can work in any geographic area based on the needs of the healthcare system and an assessment of the community’s needs. The nurse navigator may be:
With this value comes the navigation precision that patients are more connected to their care by having a single focus of contact, evaluated for other referrals and other healthcare needs such as financial, dietary, transportation, or anything else that can be met with a minimum of effort on the patient’s part—true patient-centered care. Other values of patient navigation encompass increased clinical trial participation, decrease in oncology times (treatment or diagnostic), better educated and prepared patients, and increased patient satisfaction.
Nurse navigators are also recognized as a solution to health inequities in cancer care. A basic competency of all navigators is awareness and techniques to address language and cultural differences, barriers created by these differences, and an approach to foster trust and empowerment within the communities they serve. Misconceptions that start in the community can be addressed with correct information by a trusted nurse navigator.
Many navigators work with underserved populations that need better healthcare access, advocacy, and care coordination. They use their clinical skills and talents to address deep-rooted issues stemming from distrust of providers and the health system. This bridge of trust prevents the avoidance of health problems and treatment noncompliance.
To learn more about oncology navigation, please visit our publication, Journal of Oncology Navigation & Survivorship (JONS).
To see how we reach nurse navigators, please visit Amplity Comms.