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Cancer patient navigation: program development in a large multisite cancer institute (2010-2023).

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Developing a comprehensive patient navigation (PN) program requires a phased approach, focusing on standardization and workforce training to improve cancer care coordination and access, especially for minority populations.

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Area of Science:

  • Oncology
  • Healthcare Management
  • Patient Advocacy

Background:

  • The Atrium Health Levine Cancer Institute (LCI) developed a multisite patient navigation (PN) program over 13 years.
  • This initiative aimed to create a scalable model for other institutions.

Purpose of the Study:

  • To detail the 13-year evolution of LCI's comprehensive, multisite patient navigation program.
  • To provide insights for institutions aiming to establish or enhance their navigation services.

Main Methods:

  • The program evolved through initiation, structured development, and system-wide consolidation from 2010 to 2023.
  • Key strategies included appointing a program director, using an Acuity Grading Scale, integrating PN into electronic medical records, and aligning policies with Commission on Cancer standards.
  • Employed generalist and tumor-specific nurse navigators in urban/rural settings, supplemented by virtual navigation.

Main Results:

  • The program improved care coordination, treatment initiation timeliness, and equitable access, particularly for racial and ethnic minorities.
  • Virtual navigation demonstrated efficacy during the COVID-19 pandemic.
  • Challenges involved clinician buy-in, service standardization, and funding sustainability; workforce development was supported by a navigator academy and competency evaluations.

Conclusions:

  • LCI's experience provides a replicable model for PN program development, emphasizing standardization, community needs, and workforce training.
  • Wider adoption necessitates further evidence-based standards, financial modeling, and strategies for system integration.