Quality Cancer Care
What Is Patient Navigation?
Patient navigation is a process by which an individual—a patient navigator—guides
patients with a suspicious finding (eg, test shows they may have cancer) through
and around barriers in the complex cancer care system to help ensure timely diagnosis
and treatment.1 Barriers to quality care fall into a number of categories2:
- Financial and economic
- Language and cultural
- Communication
- Health care system
- Transportation
- Bias based on culture/race/age
- Fear
Patient navigation helps ensure that patients receive culturally competent care
that is also:
- Confidential
- Respectful
- Compassionate
- Mindful of the patient's safety
Dr Harold P. Freeman, founder and national champion of patient navigation, established
the nation's first patient navigation program in 1990 at Harlem Hospital Center
to help improve access to cancer screening and address the delays in clinical follow-up
and barriers to cancer care that poor people encounter. The pilot program compared
5-year survival rates of breast cancer patients who were navigated and those who
were not and found an improvement in the navigated patients.
1Freeman HP. A model patient navigation program. Oncol Issues.
September/October 2004:44-46.
2Freeman HP. Voices of a Broken System: Real People, Real Problems. President's
Cancer Panel: Report of the Chairman 2000-2001. Reuben SH, ed. Bethesda,
Md: National Institutes of Health, National Cancer Institute; 2001.
3Oluwole SF, Ali AO, Adu A, et al. Impact of a cancer screening program
on breast cancer stage at diagnosis in a medically underserved urban community.
J Am Coll Surg. 2003;196:180-188.