Friday, April 12, 2013

The HPFPNI Patient Navigation Model

In our efforts to inform not just would-be Patient Navigators, but the general public, as well, of the ins and outs of Patient Navigation (PN), we thought we'd take this time to illustrate the window of opportunity to apply PN.

As you'll see in the chart below, this critical span of time is between the point of an abnormal finding to the point of resolution of the finding by diagnosis and treatment. This patient navigation model has been expanded to include the timely movement of an individual across the entire health care continuum from prevention, detection, diagnosis, treatment, and supportive, to end-of-life care.
Going forward, it is our hope that anyone and everyone with an abnormal finding can and will be immediately paired up with a Patient Navigator who will help them overcome any barriers to care. Also, with prevention in the mix, Patient Navigation encompasses the sharing of potentially lifesaving information with communities that might otherwise not be privy to it (including prevention measures, chronic disease facts, and important contact information). In this way, every person gets every opportunity for prevention, in addition to continual care and attention upon abnormal test results. This is a lofty goal we get up every morning thrilled to strive for!
The I in illness is isolation, and the crucial letters in wellness are we ~ Author unknown

Tuesday, April 2, 2013

Patient Navigation and Patient Advocacy

I'm reminded of Jay-Z's interpretation of the difference between rap and hip hop. He aptly likens rap to 'what you say' and hip-hop to 'what you do'. The comparison is similar here: Patient Advocacy, an extremely important segment of the patient-centric focus, is ultimately what you say. Patient Navigation, however, is what you do... It's the guiding force promoting the timely movement of the patient through a complex system of care ~ Dr. Harold P. Freeman
There are so many incredible stories out there involving Patient Navigation and how it has enabled patients with chronic diseases to overcome barriers to healthcare. Some individuals who help these patients navigate their way through the oftentimes scary, confusing, and frustrating healthcare maze are Registered Nurses. These Nurse Navigators are professionals who assist in the areas of PN that necessitate medical knowledge. Others helping the patients conquer daily healthcare hurdles are laypeople with no medical background at all who can focus instead on the administrative/logistics side of things (like transportation, daycare, daily appointments, and the like). But both irreplaceable, life-saving types of individuals have one thing in common: They were trained to become Patient Navigators.

It is understandable why there exists so much confusion out there regarding the difference between Patient Advocates and Patient Navigators. I have seen articles aplenty interchanging the monikers, oftentimes even within one sentence! There are also sites which, quite unfortunately incorrectly note that Patient Navigation is only for Cancer diagnoses (wrong!) and that Patient Navigators either must have a medical background (wrong!) or must not (wrong, again!). Simply put, Patient Navigation is a career option for people with any background. The Harold P. Freeman Patient Navigation Institution offers training for those with and without a medical background to help patients diagnosed with a chronic disease overcome any and all barriers to healthcare and to find the answers they need, when they need them. Nurse Navigators, which fall under the umbrella of Patient Navigation, are able to help in different ways that PN-trained laypeople cannot. But again, they've all got the same goal, and that is to help guide patients through the system smoothly and with the emphasis on the best patient care available.

As a final delineator, if you will, between Patient Navigation and Patient Advocacy (as mentioned in a previous post), the American College of Surgeons (ACS) Commission on Cancer issued new standards two years ago that will require cancer centers to offer Patient Navigation services by 2015 to meet accreditation requirements. These will be centers necessitating trained Patient Navigators -- not Patient Advocates. 

ALL of this said, it should be noted that every single Patient Navigator is, in fact, a Patient Advocate. Navigators -- be they laypeople trained in PN or those with a medical background who have been trained in PN -- are spokespeople/advocates for the patients in their care. Every time a Patient Navigator makes sure a patient gets transportation to her ultrasound and facilitates daycare for her children during that appointment, s/he is advocating for patient-centered care. Each time a Nurse Navigator calls an oncologist on behalf of her patient or explains the intricacies of at-home care, s/he is an advocate for better health and for moving patients in a timely manner through the continuum of care.

We at the HP Freeman PNI celebrate those who advocate for a patient-centric focus, and we train those who want to be Patient Navigators, working every day to remove the healthcare hurdles, replacing them with sure-footed possibilities for a better, healthier outcome.