August 20, 2018

Patient Navigation, Moving from Breast Cancer to Your Specialty

By Matt Zydron

 

Once considered exclusive to breast cancer treatment, patient navigation (also called patient advocacy) is making its way into other areas of medical care as a beneficial, rehabilitative praxis.

Patient navigation is not new. It had its beginnings in the 1970s, when a nurse set out to review patient records to identify issues that were delaying treatment and discharge. This research unveiled the challenge of coordinating all of the moving parts needed to navigate a patient through cancer treatment.

Fast forward to the 1990s. Dr. Harold P. Freeman, a surgical oncologist at Harlem Hospital, developed a protocol to eliminate barriers to timely cancer screening, diagnosis, treatment, and support. Data collected over years of leading his programs verified the value of navigation protocol in improving the hospital’s cancer treatment outcomes. The studies found that five-year survival rates for breast cancer patients who were involved in the program saw a significant improvement, increasing from 39% to 70%.

Today we are seeing the lessons learned from these early pioneer “nurse navigators” extend to other medical specialties. Shorter hospital stays, multiple care providers, and growing insurance complexities have made treatment more complicated. As a result, patients are finding it increasingly difficult to manage their own care. Patient navigation is gaining awareness as an emerging profession because it helps patients (and their families) steer the way through the challenges of our fragmented healthcare system. 

Hospitals typically employ nurses to serve as their in-house navigators, but more recently social workers, case managers, physicians, and even trained lay workers are becoming part of the patient navigator pool. There is no single model or standardization of services that must be offered; medical practices are developing custom programs to meet their patients specific needs and improve their outcomes.

One of the rehabilitative fields beginning to implement patient navigation is assisting patients facing limb amputation. Prosthetic practices can offer services: providing pre-amputation education, working closely with the patient’s surgeon and post-operative care team, helping find financial assistance and navigate insurance issues. They can also co-treat with physical and occupational therapists, join patients with peer supporters and extracurricular groups, support family members, and advise on any day-to-day issues that the patient may need assistance with. As with breast cancer advocacy, this walking alongside a patient who is going through a very difficult situation is not only helpful to them, but also results in improved treatment and outcomes.

There is no standardized certification for patient navigation at the present time. The Harold P. Freeman Patient Navigation Institute continues to offer in-house training and certification at their New York facility. Others are joining in providing certification for lay people and professionals who possess a baseline level of healthcare experience. As the field continues to grow, it is expected that a standardization in training and credentialing for patient navigators will follow.

For more information on patient navigation see:
Alliance of Health Care Advocates
https://aphadvocates.org

National Association of Healthcare Advocacy Consultants
http://www.nahac.com

Harold P. Freeman Patient Navigation Institute
http://www.hpfreemanpni.org

Matt Zydron, CPO is certified by the American Orthotic and Prosthetic Association and has been a practicing O&P clinician since 2002.He holds extensive knowledge in high-tech componentry and techniques, equipping him to deliver extraordinary care for high activity individuals and children. www.reachops.com