Standardized activities for lay patient navigators in breast cancer care: Recommendations from a citywide implementation study

Abstract

Background There is a need for guidelines on patient navigation activities to promote both the quality of patient navigation and the standards of reimbursement for these services because a lack of reimbursement is a major barrier to the implementation, maintenance, and sustainability of these programs. Methods A broad community‐based participatory research process was used to identify the needs of patients for navigation. A panel of stakeholders of clinical providers was convened to identify specific activities for navigators to address the needs of patients and providers with the explicit goal of reducing delays in the initiation of cancer treatment and improving adherence to the care plan. Results Specific activities were identified that could be generalized to all patient navigation programs for care during active cancer management to address the needs of vulnerable communities. Conclusions Oncology programs that seek to implement lay patient navigation may benefit from the adoption of these activities for quality monitoring. Such activities are necessary as we consider reimbursement strategies for navigators without clinical training or licensure.

Factors Influencing the Implementation of Patient Navigation Programs for Adults with Complex Needs: A Scoping Review of the Literature

“…The majority of included articles were quantitative studies (n = 36), 28 , 41 - 75 with a few qualitative (n = 16) 76 - 91 and mixed methods (n = 6). 92 - 97 Of the quantitative studies, 6 studies were randomized control trials.…”

“… 92 - 97 Of the quantitative studies, 6 studies were randomized control trials. 47 , 53 - 55 , 63 , 71 , 83 The United States (n = 50) 28 , 41 - 45 , 47 , 49 - 55 , 57 , 58 , 60 - 73 , 75 - 80 , 82 - 84 , 86 - 91 , 93 , 94 , 96 , 98 and Canada...…”

“…The initial step for most organizations was to determine the organizational need for the PNP. Many times, this was identifying barriers to care for specific patient populations (eg, Myers et al 64 and Wells et al 73 and having an organizational commitment in place to overcome barriers to care 50 , 66 , 68 , 69 , 81 , 82 , 84 , 85 , 90 , 92 , 97 ). Identifying care needs often occurred through formative research conducted by the program implementers and informed the design protocol.…”

“… 79 One program described setting timelines for each of the navigators’ responsibilities. 82 Clear inclusion and exclusion criteria for patients to enroll in the PNP, or to guide navigators in selecting patients also were established. 48 , 60 , 63 , 71 , 79 …”

Outside Our Walls: the Case for City-Wide Collaboration to Reduce Disparities

“…1 To address variation in practice, TRIP developed standardized patient navigation activities and is working with the participating sites to implement a minimum standard of patient engagement. 4 While the Massachusetts Health Information Highway (Mass HIway) has begun to establish a secure health information exchange that is accessible to all health care systems statewide, regardless of electronic health record vendor, the HIway infrastructure currently does not allow for "real-time" care coordination across institutions. TRIP therefore implemented a patient registry to track women as they receive care in sites across the city to be used by patient navigators embedded in the care delivery at each of the participating sites.…”