Patient navigation in cancer diagnostics: Providing information and support for more effective care

5 Background: Patients frequently have a difficult time finding their way through the process of diagnostic testing for cancer; the uncertainty is stressful and anxiety can impede effective communication and decision-making. Patient navigation is an ideal approach to supporting patients during the diagnostic phase of cancer care. Methods: Between 2010 and 2011, 14 Patient Navigators were trained and introduced into Diagnostic Assessment Programs (DAPs) across Ontario. DAPs are designed to provide coordination and supportive care to patients undergoing diagnostic testing and assessment. A patient survey served to evaluate the impact of patient navigation on the patient experience. Standardized tools were introduced to measure symptom severity and symptom management. Interviews were done to gauge provider and team perspectives on the role. Results: During the pilot, patient symptoms improved in the areas of well-being, tiredness, anxiety and shortness of breath, each by 30% or more. The patient survey indicated that through the program, patients got the information and support they needed; 91% of patients surveyed said that they were either satisfied or very satisfied with their experience with the patient navigator. The navigation pilot sites saw their diagnostic wait times fall by 55%. The Patient Navigators have found their work to be highly satisfying and rewarding, enjoying the opportunity it provides to use their full scope of practice in a multidisciplinary environment. Physicians expressed a high degree of satisfaction with the support provided by the Patient Navigators, reporting that patients were better prepared and informed when they arrived for their clinic appointments. Conclusions: This work has shown that patient navigation enhances the experience of patients as they move along the diagnostic continuum. Patient Navigators assist patients with managing their physical and psychosocial symptoms and play a critical role in providing the information and support patients need during a time that is full of uncertainty and distress. The diagnostic phase is a prime example of where navigation can have an impact on both the quality of patient care and the effectiveness of the health care team.