December 2012 VOL 3, NO 6

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Breast Cancer Navigation

Mary C. Rooney, RN, BSN, OCN, CBCN

Ms Rooney described the history of navigation at Crozer Keystone Health System. In 2006, breast patient navigation began at Crozer-Chester Medical Center (CCMC). The program decreased migration of inpatients out of the system from 18% to 1%, and was associated with a decrease in time-to-care and increases in satisfaction of both patients and physicians. Other benefits include screening for clinical trials and identifying high-risk patients, gaps and weaknesses in ser­vices, and opportunities for quality improvement. A lung and colorectal navigator was added in 2010.

Ms Rooney identified barriers to the navigator program, which include costs associated with the navigator, and the need for the support of the administration, physicians, and ancillary staff. Solutions to overcoming these barriers include obtaining grant support for funding and developing relationships, eg, finding a champion in one’s system. Barriers to patient participation in the navigation program include lack of access, financial problems, lack of transportation and social support, patient fear, and other issues that result in lack of adherence to treatment programs. Ways to overcome these obstacles include education, developing buddy programs for patients, and utilizing both community and national resources to support the navigation program. Ms Rooney used case examples to illustrate specific barriers and solutions to surmount them.

Take-Home Messages
A successful navigation program requires flexibility on the part of the navigator, a team approach, and the following:

  • Identifying gaps
  • Setting goals and defining how the program will be evaluated
  • Making contacts, including a point of contact with patients
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