Coffee with Komen – Patient Navigation

by Claudia Davis, RN, OCN, CBCN / Breast Cancer Navigator

We started our Breast Navigation Program at Community Health Network in 2000 at our Anderson location and eventually expanded the program to the Community North campus in 2006. By 2011, the Breast Navigation Program had expanded to include all our Indianapolis locations. Today, we employ eight dedicated breast navigators.

In 2006, the role of a patient navigator was still considered a new concept. The hospital administration at Community North conducted a focus group of breast cancer survivors. During this focus group, the patients were asked what they liked and did not like related to their breast cancer journey; and how could we improve their overall experience. The overwhelming response indicated the patients were happy with the care they received, but felt the care was fragmented. The group “loved” their physicians but did not feel the physicians communicated with each other. The results of the focus group led to the creation of the Breast Navigation Program at our Indianapolis locations.

Not all navigation programs are created equal, but the underlying premise should be the same. The navigator should help patients overcome barriers to care. Whether the barrier is gaining access to care or “navigating” the system once care has been established, the navigator should act as a guide, resource, educator and advocate for the patient and their family.

At Community Health Network, the breast navigators are registered nurses with expertise in breast health. At our Indianapolis locations the navigator officially connects with the patients at the time of diagnosis. This may differ from other programs where the navigator is introduced to the patient at the time of the diagnostic work-up. At our Indianapolis locations, the navigator is available by request during the diagnostic work-up but the official meeting takes place once the patient has been introduced to the breast surgeon.

The navigator follows the patient and family through their breast cancer journey and into survivorship. How the patient travels through the continuum of care can differ depending on the type of breast cancer the patient has. Because we have a multidisciplinary approach to breast cancer care, the team of physicians work together to formulate the best plan for each individual patient. This plan will determine how the patient moves through the continuum of care.

In my opinion, one of the most important roles of the navigator is to educate the patient so they can be active participants in the planning of their care. The patient and family should understand, for example, why they are being offered chemotherapy before surgery, or why surgery may not be indicated at all.

As a navigator, I encourage my patients to ask questions. I tell my patients once they get home and start to explain their diagnosis or treatment to family and friends and find they did not understand as well as they previously thought, call me. We will go over the information as many times as it takes until they do understand. Another role of navigation is problem solving. If the patient is experiencing a problem during their journey, it’s the navigator’s responsibility to help find the answers. It’s not the navigator’s responsibility to be the expert in every field, but it is the navigator’s obligation to direct the patient and family to the experts for the answers.

I believe that in today’s complex healthcare environment, it is essential to have a navigator by your side. Having an advocate to help break down barriers to care or having someone support you during your cancer treatment is crucial. The relationship between the patient and navigator becomes a very special bond. I’m privileged to have helped many women, and some men, through their breast cancer journeys and look forward to expanding navigation for all cancer patients in the future.

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