Navigation Refresh: The Role of the Patient Navigator in Team-Based Care

Welcome back to Navigation Refresh, a recurring, informative feature for novice and seasoned patient navigators alike. In this issue, we cover the role of patient navigators in team-based cancer care.

Team-Based Cancer Care

Cancer care is complex, often multimodal, and ever-evolving with new treatments and therapies. A broad range of disciplines support cancer patients through the cancer care continuum, requiring strong care coordination and team communication. Radiologists, medical oncologists, radiation oncologists, surgical oncologists, advanced practitioners, nurses, technologists, pharmacists, and social support staff all have critical roles to optimize patient outcomes. As healthcare becomes increasingly specialized, healthcare teams are poised to grow even larger.^1,2

In 2013, the Institute of Medicine published a report entitled Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis. The authors of that report made 10 recommendations to improve the quality of cancer care in the United States. These recommendations included optimizing patient engagement, ensuring a highly trained and coordinated workforce, expanding research to add to the evidence base, and attention to ongoing quality improvements. The report called for members of the cancer care team to coordinate with each other and with primary/geriatrics and specialist care teams to implement patients’ care plans and deliver comprehensive, efficient, and patient-centered care.³ ASCO has led several initiatives to promote team-based care, including 2 series of manuscripts focused on team-based cancer care in 2016 and 2021.⁴

The Role of the Patient Navigator

Patient navigators provide individualized assistance to patients and caregivers, communicate with clinicians, and access community resources.¹ The patient navigator must therefore be exceptional in communication skills. In fact, the Centers for Medicare & Medicaid Services list patient and family communication, interpersonal and relationship-building, service coordination, and systems navigation as core competencies required for anyone billing for the new Principal Illness Navigation G codes.⁵

Effective Communication

Effective communication requires eye contact, plain language, active listening, and attention to nonverbal cues. Active listening involves asking open-ended questions and listening to patients’ responses, observing both verbal and nonverbal cues, clarifying information, and clarifying the patient’s understanding of the information provided. Reflecting back what the patient said through summarizing is also a strategy to ensure communication is clear.^1,2

Patient-centered communication improves patient trust. This can look like validating patient emotions, encouraging patients to ask questions to their clinical care team, supporting patient self-advocacy, and centering patient values and goals of care.^1,2

You can remember the acronym EMPATHY to employ patient-centered communication⁶:

Eye contact

Muscle of facial expression

Posture

Affect

Tone of voice

Hearing the whole person

Your response

This tool is particularly helpful in noting nonverbal aspects of communication, especially in scenarios where patients may not want to openly disagree with their doctor.⁶

Effective Teams

Not all teams work well together. Competing goals and lack of role clarity can impede team-based care, whereas leadership modeling team orientation and technology to assist with communication can improve team-based care.⁴

Effective communication is critical for effective team dynamics. Other aspects of effective teams include clear understanding of each team member’s scope of practice, strong interpersonal relationships, consistency in working with the same team members, and working at the top of one’s scope of practice.⁷ Diversity of skills and perspectives in the context of psychological safety (such as the ability to speak up about something that may be out of protocol regardless of the person’s role on the team) are also major contributors to effective team performance.⁸

The patient navigator plays a key role in effective teams by employing patient-centered communication, building strong interpersonal relationships with colleagues, and helping everyone on the team work at the top of their license.^1,2

Alignment With PONT Standards

This edition of Navigator Refresh aligns with standards 6 (Communication) and 16 (Advocacy) of the Professional Oncology Navigation Task Force (PONT) standards: All navigators should communicate effectively to ensure patient safety and satisfaction and to advocate with and on behalf of patients (Standard 6). All navigators should work with patients to identify and communicate their goals, preferences, and values to support optimal experiences and outcomes (Standard 16).⁹

References

1. The GW Cancer Center. (PI: Pratt-Chapman). GW Oncology Patient Navigator Training: The Fundamentals. 2025. bit.ly/PNTraining
2. The GW Cancer Center. (PI: Pratt-Chapman). GW Oncology Patient Navigator Training 2025 Guide. 2025. https://bit.ly/PN-Guide2025
3. Institute of Medicine. Delivering High-Quality Cancer Care. Charting a New Course for a System in Crisis. Washington, DC. 2013. https://nap.nationalacademies.org/resource/18359/qualitycancercare_rb.pdf
4. Kosty MP, Chollette V, Weaver SJ, Cox JV. Toward team-based cancer care in the United States: 6 years later. JCO Oncol Pract. 2023;19:3-5.
5. Centers for Medicare & Medicaid Services. Medicare and Medicaid Programs; CY2025 Payment Policies Under the Physician Fee Schedule and Other Changes to Part B Payment and Coverage Policies; Medicare Shared Savings Program Requirements; Medicare Prescription Drug Inflation Rebate Program; and Medicare Overpayments. Federal Register. 12/9/2024.
6. Reiss H, Kraft-Todd G. E.M.P.A.T.H.Y.: a Tool to Enhance Nonverbal Communication Between Clinicians and Their Patients. Acad Med. 2014;89:1108-1112.
7. Lambert LK, Havaei F, Beck SM, et al. An early evaluation of team consistency and scope optimization in team-based cancer care. BMC Cancer. 2025;25:371.
8. Bresman H, Edmondson AC. Research: To Excel, Diverse Teams Need Psychological Safety. Harvard Business Review. https://hbr.org/2022/03/research-to-excel-diverse-teams-need-psychological-safety
9. Franklin E, Burke S, Dean M. Oncology Navigation Standards of Professional Practice. Journal of Oncology Navigation & Survivorship. 2022:13(3):74-85.