1. Breast Cancer Nurse Navigation Rosemary Clement MSN, APRN-BC, Certified Breast Care Navigator

2. Breast Care and the Role of the Navigator Breast Cancer has become a special field of cancer care Unlike other diseases, there is usually many kinds of doctors and treatments involved The model of patient navigation has been shown to be successful in helping patients navigate through the cancer trajectory and to help save lives

3. History of Patient Navigation In 1989, Dr. Harold P. Freeman, as president of the ACS, held nationwide hearings that determined that poor patients face enormous barriers when attempting to obtain cancer care In 1990, he established the U.S.’s first patient navigation program at Harlem Hospital in New York

4. Harlem Hospital Studies Data was collected on the outcomes of the program and compared five year survival rates 1964-1986 vs 1995-2000 39% 70% “We believe that this survival improvement was primarily a result of patient navigation.” H. P. Freeman, MD

5. Patient Navigation Act On June 29, 2005, President George W. Bush signed into law the: “Patient Navigator, Outreach, and Chronic Disease Prevention Act” -provides funding to create patient navigation services

6. The Patient Navigator One person who guides the patient through the health care system and follows the patient from diagnosis through treatment Addresses and anticipates obstacles to care

7. Goals of Patient Navigation To Save Lives from Cancer -timely diagnosis and treatment -educate populations on cancer prevention and early detection

8. Goals of Patient Navigation To Eliminate Barriers to Care -make sure patients are aware of and can access available services -make sure patients are not “lost” in the follow up

9. Navigator Role and Responsibility Outreach -expand availability of screening services -community education of early detection and cancer prevention Patient Navigation -provide navigation from suspicious finding to resolution

10. Navigator Role and Responsibility Rehabilitation -provide education/support for issues related to surviving cancer -lymphedema specialist -support groups -financial help

11. Navigator Resoures Financial support services Language and translation services Rehabilitative services Palliative care services Community outreach educational services Family and support services Local advocacy and support services

12. Navigator Tasks Bridging cultural and linguistic barriers Finding financial resources Tracking appointments Coordinating transportation Referring patients, families and caregivers to appropriate services

13. Initial Needs of the Breast Cancer Patient Timely Diagnosis Disease Education Financial Needs Assessment Family and Social Assessment Family Genetic Assessment Nutritional Assessment

14. Needs of the Breast Cancer Patient Prosthesis and mastectomy bras JP holder or camisole Wigs, scarves, hats Eyeglasses Walkers Wheelchairs childcare

15. Nurse Navigator Qualities Confidentiality Respectfulness Compassionate Mindful of the patient’s safety

16. Good Patient Communication Empathy Sincerity Engagement/Connection with patient Clarification of Patient’s concerns, and knowledge of disease Enlistment of partnership in care

17. Benefit to Organizations Better sharing of resources Improved patient care Cost savings Enhanced quality of services Increased patient satisfaction Greater community partnership