Nurses as patient navigators in cancer diagnosis: review, consultation and model design

Abstract

The diagnostic phase of cancer care is an anxious time for patients. Patient navigation is a way of assisting and supporting individuals during this time. The aim of this review is to explore patient navigation and its role in the diagnostic phase of cancer care. We reviewed the literature for definitions and models of navigation, preparation for the role and impact on patient outcomes, specifically addressing the role of the nurse in patient navigation. Interviews and focus groups with healthcare providers and managers provided further insight from these stakeholder groups. Common to most definitions of navigation is the navigator's multifaceted role in facilitating processes of care, assisting patients to overcome barriers and providing information and support. Navigation may be provided by laypersons, clerical staff and/or healthcare professionals. In the diagnostic phase it has the potential to affect efficiency of diagnostic testing, patients' experience during this time and preparation for decision-making around treatment options. Patient care during the diagnostic phase requires various levels of navigation, according to individual informational, physical and psychosocial needs. Identifying those individuals who require more support--whether physical or psychosocial--during the diagnostic phase is of critical importance.

Regional Process Redesign of Lung Cancer Care: A Learning Health System Pilot Project

“…Reports on reduction of waiting time for cancer patients consist largely of single interventions for care coordination, task automation, and organizational restructuring. These include multidisciplinary clinics, nurse-led care coordination, telemedicine, and standardized expedited diagnostic processes [38][39][40] . Most of these isolated interventions fail to improve the total wait time of the entire patient journey to treatment.…”

A Collaborative Step-Wise Process to Implementing an Innovative Clinic for Adult Survivors of Childhood Cancer

“…This challenge was met by identifying the role of a transition nurse navigator to serve as the conduit among patient, providers and survivorship clinic. The benefit of a nurse navigator with an oncology background is the ability to assess and educate patients, alleviate anxiety as he/she facilitates the transition for survivors between the CMH survivorship clinic and KUCC Survivorship Transition Clinic (STC) and communicate with clinicians regarding complex care issues (Gilbert et al, 2011). Another key role of the navigator is to gather records from outside facilities for patients referred from other treatment centers or who did not receive a treatment summary at time of completion of therapy.…”

Effect of Nurse Navigation on Patient Care Satisfaction and Distress Associated With Breast Biopsy

“…Women need information regarding their risk of having cancer and the tests necessary to diagnose the disease. Women who are adequately informed about the process are less distressed, cope better with the possibility of having cancer, have more trust in the healthcare team, and are better able to discuss and participate in decision making regarding treatment options with the healthcare provider (Gilbert et al, 2011;Harding, 2014;Liao, Chen, Chen, & Chen, 2010). Having a specific professional for women to contact with questions and to clarify any information lessens distress, as does receiving diagnostic test results in a timely manner (Liao et al, 2010).…”