Patient Navigators at the Center of Cancer Care Teams

Since its inception in 1990, patient navigation has become a vital component of cancer care. Today the patient care navigator is at the hub of a wheel of complex care delivered by a multidisciplinary team of specialists.

A proven approach

The first patient navigation program, launched by oncologist Harold Freeman, MD, sought to expand access to cancer screening and follow-up care for African American women living in Harlem, NY. Incredibly successful, the pilot program improved the 5-year survival of women with breast cancer participating in the program from 39% to 70%.

In 2005, the federal government funded research on the impacts of patient navigation, and by 2012, the American College of Surgeons’ Commission on Cancer required all COC-accredited organizations to have a patient navigation program.

The navigator’s role

Patient navigators are trusted to provide evidence-based, unbiased information to educate patients about the diagnostic and treatment processes so that they can make informed decisions about their care. They provide emotional and psychosocial support and help patients overcome potential barriers to care.

“We assist with scheduling appointments, arranging transportation and interpretation services, and accessing financial assistance and community-based resources,” explains Mary Smith, RN, BS, CBCN, a breast health navigator with the Robert and Carol Weissman Cancer Center at Cleveland Clinic Martin Health. “We are there for our patients and provide ongoing support across the care continuum, from screening, diagnosis, and treatment to cancer survivorship.”

Benefits of patient navigation

Patient navigation is designed to enhance patient experiences and the delivery of cancer care by increasing cancer treatment adherence, reducing care delays, and promoting education and lifestyle changes in survivorship care. Research demonstrates that patients experience lower levels of distress, anxiety, and depression when they receive this level of support.

“Studies have shown a significant survival benefit for patients who receive care navigation,” says Smith. “In addition to reducing time to treatment, navigation services can improve patient knowledge of their cancer and lead to better communication with their care team, all of which can improve patient outcomes.”

Frictionless transition of care

Cleveland Clinic Florida’s five-hospital regional health system has a team of 18 patient navigators deployed across three COC-accredited centers — the Robert and Carol Weissman Cancer Center (Cleveland Clinic Martin Health), the Scully-Welsh Cancer Center (Cleveland Clinic Indian River Hospital), and the Maroone Cancer Center (Cleveland Clinic Weston Hospital). Combined they guide thousands of patients a year through their treatments for solid tumor and blood cancers.

According to Smith, monthly regional meetings bring together the three teams to share best practices and collaborate on the care of patients receiving treatment at multiple Cleveland Clinic locations across the region. “Our navigators help streamline care team coordination, reducing friction that could otherwise delay time to treatment.”

She cites the case of a Cleveland Clinic Martin Health patient with head and neck cancer who underwent surgery at Cleveland Clinic Indian River Hospital. In another example, Smith says the team helped a Cleveland Clinic patient from Ohio diagnosed with neuroendocrine cancer who was moving to Florida. The patient underwent surgery at Cleveland Clinic Weston Hospital and medical oncology care at Cleveland Clinic Martin Health.

“In these situations, the expedited transition of care reduces time to treatment, an important metric for any cancer program,” says Smith, noting the Robert and Carol Weissman Cancer Center team will soon conclude a quality study on that very issue in preparation for an upcoming three-year COC reaccreditation survey. “It also reduces the level of anxiety patients experience, the benefit of which can be harder to quantify but is no less important.”