Patient navigators have been around for a couple of decades, but for many hospitals, adding that position to their already hefty and expensive staffing load hasn't been a priority. Maybe it's time to change that thinking.


With new federal mandates to meet quality of care and patient experience goals, more and more hospitals are comparing the cost vs. benefits of hiring these professionals and concluding that they're well worth the investment. Our aging population, the rise in chronic disease, the increasing complexity of diseases and treatments, and the reimbursement sharing by providers across the care continuum that will come with bundled payments help make the case as well.

But first you need to understand exactly what patient navigators do, what training they need and how their roles complement rather than conflict with nurses, social workers and others on the care team.

To help sort all that out, the Center for Health Affairs, an advocacy organization for hospitals in Northeast Ohio, has produced a nifty, easy-to-digest report called The Emerging Field of Patient Navigation: A Golden Opportunity to Improve Healthcare. The report argues that for many patients, in particular those with chronic diseases like diabetes and cancer, the complexity of our health system keeps them from getting the care they need. Many don't receive the correct treatment early enough to prevent their illnesses from becoming more serious than they might have. Or they are confused by the multiple clinicians and medications involved in their treatments. Some financially challenged patients don't know about the services available to transport them to hospitals or other care settings, or to help them pay for expensive prescriptions. And many simply fail to follow post-discharge instructions and end up back in an inpatient bed — a serious problem considering the penalties looming for hospitals with high rates of avoidable readmissions.

The CHA report cites evidence of how navigators can help. For example, Harold P. Freeman, M.D., the pioneer of the patient navigation movement, found that uninsured or underinsured women with breast cancer in his hospital had much higher mortality rates than those with insurance, partly because they tended to be diagnosed at later stages. Providing "culturally competent" patient navigators and free or low-cost mammograms increased the five-year survival rate for breast cancer patients from 39 percent to 70 percent.

Another example: Navigators can reduce no-show rates for appointments, which is not only good for the patients, but also ensures that providers don't lose revenue for missed visits.

And patient navigators can be especially helpful in addressing health disparities. "For all patients, including those with cultural, socio-economic or language barriers, roadblocks take many forms," the authors write. "With support from a navigators on financial issues, communication challenges and emotional strain, the likelihood of successful treatment increases. Over the long run, this type of guidance has the potential to mitigate disparities for entire communities."

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