BREAST CARE PATIENT NAVIGATION

Breast Care Navigators are typically people that have a passion in caring for others. The role of a Breast Care Navigator is varied, often becoming an advocate for our patients and a liaison between the medical providers for each patient. The main goal always remains constant – making sure there are no barriers to care for each and every patient. The first patient navigation program in the United States was established by Harold P. Freeman, M.D. in a Harlem Hospital. Dr. Freeman found that some people had an inability to access complex and often confusing cancer care services. He found that the poor and medically underserved patients suffered a higher cancer mortality rate. Therefore his goal was to advance access to cancer screenings and address delays/barriers to care. He wanted to make sure that every person with a suspicious finding received a timely diagnosis and treatment disregarding minority and their socioeconomic situation. Since 1990, there have been studies done that show there is evidence to support the role of patient navigation in breast cancer to improve many aspects of cancer care. The pilot program compared five year survival rates for breast cancer patients who were navigated and those who were not, and found a marked improvement in the navigated patients. Breast cancer is an optimal area for patient navigation because of known survival benefit of early detection through clinical breast exam, mammograms, and early intervention. It is also important in breast cancer because of documented racial disparity in breast cancer care across the country. In studies they found that even though there were many efforts toward coordination of care for women with early stage breast cancer, there were no consistent methods to track care or receipt of care as well as missed appointments. When breast cancer patients are diagnosed many patients experience emotional turmoil, they have informational needs, and some have logistical challenges. As a Breast Care Navigator, you have to look at each individual patient and tailor your assistance to their needs. The navigator is the one constant for patients, health care providers, and community partners. They become a liaison between all of the doctors and services a breast cancer patient uses. It is very important that patients are educated about breast cancer so that they can make an educated decision about their care. The navigator plays a very important role in this by supplying vital information about options available to them. We are often like a “personal assistant” to the patient. A navigator needs to be compassionate, resourceful, organized, a good communicator, and able to solve problems creatively. When communicating with a patient, they need to be sincere and listen to the patient’s wants and needs. The Breast Care Navigator should enlist the patient to become proactive in their care by educating them. They often bridge any gaps to help patients and their families get through the complex healthcare system in a timely manner. We want to make sure the patients do not “fall through the cracks” because of disconnect between health care providers, community services, and cancer centers. It is important for the Breast Care Navigator to start an open line of communication for the patient at the time of diagnosis and in some cases, suspicious findings. The navigator sets up referral appointments as well as accompanying patients to some or all of their first appointments if possible. They often assist in referring patients to appropriate sources for needed items such as post-surgical compression bras, etc. A navigator should do their best to help streamline appointments for each patient based on their needs. A Breast Care Navigator should track care from suspicious finding through treatment and survivorship. They monitor a patient’s progress and if an appointment is missed they should find out why and get the appointment rescheduled. Navigators want to help patients stay on track with their treatment plan. After treatments, a navigator continues to monitor patients closely and helps the patient in scheduling follow-up appointments. It is equally important to follow both malignant and benign findings to ensure proper follow-up care is being provided. This improves the quality of care for each patient having suspicious findings. Breast Care Navigators can help breast cancer patients immensely by providing the following: 1. Save lives for women by scheduling patients with suspicious findings so that they receive a timely diagnosis and treatment. 2. Eliminate any barriers to care by providing access to available services and ensuring patients are not lost in follow-up care 3. Ensure timely delivery of services – moving patients through the complex healthcare system to provide the best patient care possible. I have had over 20 years of experience in women’s health. I take pride in meeting the comprehensive needs of our patients and fulfilling my role as a Breast Care Patient Navigator. I am inspired every day by the strength of women diagnosed with breast cancer and I want to do everything I can to help them along that journey.