About Patient Navigation

Patient navigation in the cancer care setting refers to individualized assistance offered to patients, families, and caregivers to help overcome healthcare system barriers and facilitate timely access to quality health and psychosocial care from pre-diagnosis through all phases of the cancer experience.1

Principles of Patient Navigation2

  1. Patient navigation is a patient-centric healthcare service delivery model.
  2. Patient navigation serves to virtually integrate a fragmented healthcare system for the individual patient.
  3. The core function of patient navigation is the elimination of barriers to timely care across all segments of the healthcare continuum.
  4. Patient navigation should be defined with a clear scope of practice that distinguishes the role and responsibilities of the navigator from that of all other providers.
  5. Delivery of patient navigation services should be cost-effective and commensurate with the training and skills necessary to navigate an individual through a particular phase of the care continuum.
  6. The determination of who should navigate should be determined by the level of skills required at a given phase of navigation.
  7. In a given system of care there is the need to define the point at which navigation begins and the point at which navigation ends.
  8. There is a need to navigate patients across disconnected systems of care, such as primary care sites and tertiary care sites.
  9. Patient Navigation systems require coordination.

References: 

  1. Oncology Nursing Society (ONS), Association of Oncology Social Work (AOSW), & National Association of Social Workers (NASW). (March 2010).  Joint Position on the Role of Oncology Nursing and Oncology Social Work in Patient Navigation.

  2. Freeman HP, Rodriguez RL. History and principles of patient navigation. Cancer. 2011 Aug;117(15 Suppl):3539-42.

“No person with cancer should have to spend more time fighting their way through the cancer care system than fighting their disease.”

– Dr. Harold P. Freeman, President and CEO of the Harold P. Freeman Patient Navigation Institute

“In today’s complex world of oncology care, with phases of treatments being fragmented, costly, and some decisions being confusing, cancer patients need to be able to rely on a navigator for support. This individual is their patient advocate, their educator, and their problem solver identifying and eliminating barriers to care. Navigators help ensure they don’t fall through the cracks and empowers them so they can actively participate in the decision making about their treatment across the continuum of care.”

– Lillie Shockney, Program Director and Co-Founder, Academy of Oncology Nurse & Patient Navigators

History & Evolution of Patient Navigation

Timeline

Timeline
1971

National Cancer Act signed

1989

Report to the Nation: Cancer in the Poor

1990

First Patient Navigation Program launched by Dr. Harold Freeman

1994

Native America Cancer Research Corp (NACR) Native Sisters Program and Training launched

2005

Patient Navigator Outreach and Chronic Disease Prevention Act (HR 1812)

Patient Navigation Research Program

C-Change defines Patient Navigation

American Cancer Society launches Patient Navigator Program

2007

NCI Community Cancer Centers Program established and includes patient navigation

2008

Harold P. Freeman Patient Navigation Institute launches

2009

Academy of Oncology Nurse & Patient Navigators (AONN) formed

Association of Community Cancer Centers (ACCC) Cancer Program Guideline 1: Patient Navigation Services released

2010

ONS, AOSW, NASW, Joint Position on the Role of Oncology, Nursing and Oncology Social Work in Patient Navigation

National Patient Navigation Leadership Summit held, navigation outcomes & metrics published in Cancer (2011)

2012

Commission on Cancer releases Patient Navigation Process Accreditation Standard 3.1

2013

ONS releases Oncology Nurse Navigator Core Competencies

2015

George Washington Cancer Institute publishes core competencies for oncology patient navigators and releases an online fundamentals of patient navigation

2016

AONN launches Oncology Nurse Navigator (ONN-CG℠) and Oncology Patient Navigator (OPN-CG℠) Certification Exams

Center for Medicare and Medicaid Innovation’s (CMMI) Oncology Care Model begins and includes patient navigation requirement

2017

AONN releases 35 evidence based navigation metrics

Launch of the National Navigation Roundtable