Gu Uide F for Pat Tient T Na Avig Gator Rs

Total Page:16

File Type:pdf, Size:1020Kb

Gu Uide F for Pat Tient T Na Avig Gator Rs Guide for Patient Navigators A SUPPLEMENT TO THE ONCOLOGY PATIENT NAVIGATOR TRAINING: THE FUNDAMENTALS Cancer Instituute Oncology Patient Navigator Training: The Fundamentals George Washington University (GW) Cancer Institute © 2015 TABLE OF CONTENTS WELCOME ............................................................................................................................. i Acknowledgements ............................................................................................................... ii An Overview of the Training ................................................................................................. iv MODULE 2: AN OVERVIEW OF PATIENT NAVIGATION AND COMPETENCIES…………………..1 Principles of Patient Navigation ............................................................................................ 2 Patient Navigator Competencies .......................................................................................... 3 Relevant Articles on Patient Navigation ............................................................................... 7 Resources for Patient Navigators ......................................................................................... 7 References ............................................................................................................................ 8 MODULE 3: THE BASICS OF HEALTH CARE Lesson 1: Medical Terminology ........................................................................................... 10 Prefixes, Roots and Suffixes .................................................................................................. 11 Common Words Used in Cancer ........................................................................................... 18 Medical Terminology Cheat Sheet ........................................................................................ 19 Resources for Patient Navigators ......................................................................................... 21 References ............................................................................................................................ 22 Lesson 2: Cancer Basics ........................................................................................................ 23 Defining Cancer ..................................................................................................................... 24 Cancer Risk Factors and Prevention ..................................................................................... 27 Screening and Testing to Detect Cancers ............................................................................. 29 Cancer Staging....................................................................................................................... 31 Cancer Treatment ................................................................................................................. 31 Tips for Selecting a Complementary Health Practitioner ..................................................... 35 Resources for Patient Navigators ......................................................................................... 36 Resources for Patients .......................................................................................................... 36 References ............................................................................................................................ 38 Lesson 3: Clinical Trials ......................................................................................................... 41 FAQs About Clinical Trials ..................................................................................................... 42 Patient Protections ............................................................................................................... 46 Oncology Patient Navigator Training: The Fundamentals George Washington University (GW) Cancer Institute © 2015 The Navigator Role in Clinical Trials ...................................................................................... 47 Helping Patients Understand Clinical Trials .......................................................................... 48 Possible Questions to Ask Patients ....................................................................................... 48 How to Find Clinical Trials ..................................................................................................... 49 Resources for Patient Navigators ......................................................................................... 50 Resources for Patients .......................................................................................................... 50 References ............................................................................................................................ 51 Lesson 4: Impact of Cancer .................................................................................................. 53 Physical, Psychosocial, Practical and Spiritual Impacts ........................................................ 54 Issues Unique to Adolescents and Young Adults (aged 15‐40) ............................................ 55 Issues Unique to Those Living with Advanced Cancer .......................................................... 55 Post‐Treatment Survivorship ................................................................................................ 56 Resources for Patient Navigators and Patients .................................................................... 58 References ............................................................................................................................ 59 Lesson 5: U.S. Health Care System ...................................................................................... 62 Cancer Care Delivery ............................................................................................................. 63 Overview of Health Care Specialists ..................................................................................... 64 Overview of Oncology Specialists ......................................................................................... 67 Mental Health Professionals ................................................................................................. 67 Resources for Patient Navigators ......................................................................................... 68 References ............................................................................................................................ 69 Lesson 6: Health Care Payment and Financing ................................................................... 71 A Dictionary of Common Health Insurance Terms ............................................................... 72 Types of Health Insurance and Eligibility .............................................................................. 76 Federal Poverty Guidelines ................................................................................................... 77 Health Plan Type Comparison ............................................................................................... 78 Affordable Care Act ............................................................................................................... 79 Resources for Patient Navigators ......................................................................................... 80 Resources for Patients .......................................................................................................... 80 References ............................................................................................................................ 81 Oncology Patient Navigator Training: The Fundamentals George Washington University (GW) Cancer Institute © 2015 MODULE 4: THE BASICS OF PATIENT NAVIGATION Lesson 1: The Role of the Patient Navigator………………………………………………………………….. 83 The Patient Navigator’s Role ................................................................................................ 84 Sample Patient Navigator Job Description ........................................................................... 85 Possible Barriers .................................................................................................................... 87 Patient Navigator Duties ....................................................................................................... 88 A Day in the Life of a Patient Navigator ................................................................................ 89 Resources for Patient Navigators ......................................................................................... 91 References ............................................................................................................................ 92 Lesson 2: Patient Assessment…………………………………………………………………………………………94 The 5 A’s ................................................................................................................................ 96 Sample Patient Intake Form ................................................................................................. 97 Barriers Assessment Tool ...................................................................................................... 98 Tips for Building Rapport ...................................................................................................... 99 Tips for Asking and Assessing ..............................................................................................
Recommended publications
  • Implementing an Integrated Healthcare System in Kentucky
    Implementing an Integrated Healthcare System in Kentucky Kentucky Public Health Leadership Institute Scholars: Leslie Aitken; BBA, CPA Director of Administrative Services; Clark County Health Department Anne Hatton; RN Clinic Nurse Administrator; Clark County Health Department Olivia Whitman; MPH Community Health Development Coordinator; Clark County Health Department Mentor(s): April Harris; M.P.H., CHES Deputy Director/Accreditation and QI Coordinator; Three Rivers District Health Department EXECUTIVE SUMMARY: Currently, the U.S. is ranked 1st in healthcare spending and 26th in life expectancy among OECD countries and life expectancy in Kentucky is below the U.S. national average.1 The Affordable Care Act (ACA), which was signed into law in March of 2010, included comprehensive health insurance reforms aimed at increasing the quality of healthcare services provided and decreasing the cost of healthcare.2,3 In 2014 the rollout of Kynect, Kentucky’s official marketplace for insurance under ACA, resulted in the second largest decrease in the uninsured rate in the country.3 To-date approximately only 11% of Kentuckians are uninsured yet, Kentucky still ranks 44th in the nation in terms of health outcomes.4 The following paper reviews the potential barriers to receiving healthcare, along with the five model types of integrated healthcare systems and the features of each that could alleviate some of those barriers. INTRODUCTION/BACKGROUND: In the United States 17.5% of the Gross Domestic Product (GDP) is spent on healthcare, which is about $3.0 trillion dollars as a nation, and $9,523 per person.5 However, the current life expectancy of an American is, only, approximately 76 years of age for males and 81 years of age for females.1 Currently, the U.S.
    [Show full text]
  • Emerging Field of Patient Navigation By: Brian E
    Emerging Field of Patient Navigation By: Brian E. Daly, EdD Welcome to the Patient Navigation World Patient Navigation is a challenging healthcare career path. Recently, I experienced this role as my injured spouse dealt with a broken wrist and foot, limited mobility, denial of services from an insurance company, excessive prescription costs, and conflicting treatment plans (we had to go two different physicians for treatment of the wrist and foot). Although I have had many experiences working healthcare issues with friends and family, these recent challenges made me think – “I wish I had a competent patient navigator to help with this morass.” Healthcare is moving to a patient-centered, evidence-based approach but it will need the help of patient navigators, advocates, and community health workers to get there. A disjointed medical care system desperately needs the skills of these navigation professionals. Defining Patient Navigation Simply put, patient navigation is having a “mom.” As a patient, I am in a poor position to handle all the challenges that arise during my treatment. I just can’t take in all the noise and only hear part of the message. I am directed to do things to improve my health status but I don’t hear the whole message. I am too busy sorting out what I know and what I imagine. Despite being focused on improving my health, there are too many distractions. My emotional state confuses my rational state. In season one of the TV series “Breaking Bad” a high school chemistry teacher is diagnosed by his physician as having cancer.
    [Show full text]
  • Safety-Net Hospital Systems Transformations in the Era of Health
    Safety-Net Hospital Systems Transformation in the Era of Health Care Reform Experiences, Lessons, and Perspectives from 13 Safety-Net Systems Across the Nation February 2015 D EVELOPED BY T E X A S H E A L T H I N S T I T U T E S U P P O R T E D B Y B L U E S H I E L D O F C A L I F O R N I A F OUNDATION Project Support Provided by: Blue Shield of California Foundation Project Team at Texas Health Institute: Dennis P. Andrulis, PhD, MPH, Senior Research Scientist Nadia J. Siddiqui, MPH, Senior Health Policy Analyst Swapna Reddy, JD, MPH, Health Policy Analyst Lauren R. Jahnke, MPAff, Health Policy Consultant Maria R. Cooper, MA, Health Policy Analyst Acknowledgements: We thank the many hospital executives at the following systems who generously shared their time, candid perspectives, and resources to inform this project: Boston Medical Center Elmhurst Hospital Center (NYCHCC) Cambridge Health Alliance UK HealthCare Hospital System Cook County Health & Hospitals System UW Harborview Medical Center Hennepin County Medical Center Clinica Family Health Services Maricopa Integrated Health System Maui Memorial Hospital MetroHealth System Yuma District Hospital Mount Sinai Hospital of Chicago We also thank Rachel Wick, Program Officer, Blue Shield of California Foundation, for her guidance and feedback throughout this project. Finally, we thank Anna Schellhase, THI Policy Intern, for her research assistance and support. Texas Health Institute 8501 North Mopac Expressway, Suite 170 Austin, Texas 77584 (512) 279-3910 http://www.texashealthinstitute.org/health-care-reform.html Safety-Net Hospital Systems Transformation in the Era of Health Care Reform 2 Table of Contents Introduction.......................................................................................................................
    [Show full text]
  • Minnesota Action Plan to Improve Health Literacy
    Minnesota Action Plan to Improve Health Literacy March 2016 Foreword With more and more people accessing health insurance in Minnesota, it is important to equip them with the information needed to navigate the health care system and take action to maintain and improve their health. Health literacy – skills necessary for an individual to participate in the health care system and maintain good health1 – has become increasingly concerning. Nearly 9 out of 10 adults have difficulty using the everyday health information that is routinely available in our health care facilities, retail outlets, media, and communities.2 Over the past several years, the health care system has experienced an unprecedented level of change, which has compounded this problem. Our responsibility as a health care community is to communicate clearly. Without clear communication, we cannot expect people to adopt healthy behaviors, follow medical advice, or understand their health insurance plans. When people receive accurate, easy-to-understand information about a health issue, they are better able to take action to protect and improve their health and wellness. For this reason, health equity has become a critical topic for health professionals and community organizations. Health equity aims to ensure that every person has the opportunity to attain his or her full health potential and no one is disadvantaged from achieving this potential because of his or her social position or other socially determined circumstances.3 Health equity implies that health should not be compromised or disadvantaged because of an individual or population group’s race, ethnicity, gender, income, sexual orientation, neighborhood or other social condition.4 To build a healthier society, it is important that organizations work together to improve health equity.
    [Show full text]
  • Social Work's Contribution to Patient Navigation Patricia Louise
    Promoting Socially Just Healthcare Systems: Social Work’s Contribution to Patient Navigation Patricia Louise Desrosiers Gayle Mallinger Tonya Bragg-Underwood Abstract: Patient navigation is an emerging area of healthcare practice that uses an interdisciplinary and integrated care model designed to reduce health disparities and improve health outcomes. The authors define patient navigation, delineate the alignment of social work competencies with patient navigator requirements, and argue for a clear social work role and presence as patient navigators in interdisciplinary healthcare delivery. Social workers are well-equipped to carry out a variety of patient navigator responsibilities due to their unique skill of social justice advocacy as a macro-level intervention. Through involvement in patient navigation, social work leaders can promote the development of socially just healthcare systems that respect the dignity and worth of all patients. Keywords: Patient navigation; health disparities; social work roles; interdisciplinary teams Patient navigation is an emerging area of healthcare practice designed to assist patients in negotiating complicated healthcare systems. This patient-centered approach promotes improved health outcomes and diminished health disparities. Specifically, patient navigators (PNs) assist medically needy individuals to overcome barriers to treatment. Thus, navigators are charged with coordinating services, organizing transportation, and arranging for translation and financial support. In addition, the navigator provides emotional support and patient education. Complex patients, including those with multiple diagnoses, diverse cultural backgrounds, or special needs, such as hearing or vision impairments, are often inundated with a variety of helpers. Navigators aim to reduce confusion and frustration for patients. Consider the fictitious case of Sally, a 70-year-old African American female with high blood pressure who is not having success following her doctor’s orders.
    [Show full text]
  • Unlocking the Complexity of the Health Care System: Kentucky’S Health Navigators
    Unlocking the Complexity of the Health Care System: Kentucky’s Health Navigators Unlocking the Complexity of the Health Care System: Kentucky’s Health Navigators BY Michael T. Childress RESEARCH SUPPORTED BY The Foundation for a Healthy Kentucky OCTOBER 2012 College of Communication and Information 308B Lucille Caudill Little Fine Arts Library University of Kentucky Lexington, KY 40506‐0224 Center for Business and Economic Research 335AV Gatton College of Business and Economics University of Kentucky Lexington, KY 40506‐0034 859.257.2912 office 859.257.7671 fax [email protected] Page | i Page | ii PREFACE ealth navigation comes in many forms. Sometimes it takes the form of helping an individual find the treat‐ ment, medication, or health services they need. Other times navigation takes the form of helping a patient H overcome barriers of child care, finances, or transportation so they can see a doctor. In other cases naviga‐ tion means working with patients to enhance health literacy so they comply with medical instructions and are not readmitted to a hospital. And sometimes health navigation entails lending an empathetic hand to patients under‐ going the rigors of cancer treatment. Here we adopt a fairly broad definition of what constitutes “health navigation.” We include individuals, groups, and agencies that most would agree are health navigators. At the same time, in the course of this research we came across many individuals who view themselves as health navigators—even if the purists do not. In general we err on the side of inclusion and encourage readers to make their own judgments. We also estimate the under‐ lying demand for navigation services across Kentucky and conclude that the need for navigation is likely greater than the existing capacity.
    [Show full text]
  • Washington Low Income Housing Alliance Successful Outreach & Enrollment Strategies for Homeless People in the Affordable Care Act
    Washington Low Income Housing Alliance Successful Outreach & Enrollment Strategies For Homeless People in the Affordable Care Act Yakima Neighborhood Health Services Annette Rodriguez, Homeless / Housing Director Navigators / In Person Assisters 2 Lead Organization Responsibilities Build local network of community-based organizations Lead outreach and education activities for service area Train Navigators within the service area Financial agent for network partners Performance monitoring Reporting 3 State and County Projections Projected Projected Uninsured Uninsured Percent of Population Population Estimated who would Population by of who would qualify for who would 12/31/2013 Uninsured qualify for subsidies benefit under age Medicaid from the 65 Expansion ACA Yakima 250,600 76,800 * 30,800 24,500 72% ** County Kittitas 42,100 8,400* 3,100 3,200 75%** County Two County 292,700 85,200* 33,900 27,700 Total Washington 6.9 million 1.1million 328,000 447,400 74% State 5 Homeless Service Providers -- Opportunities Need for In -reach in Yakima/Kittitas Counties Community Health Centers # of Patients at 3 Medicaid % of Uninsured % of County CHCs County Uninsured Medicaid Children 34,150 59% 3,632 39% Adults 11,000 45% 21,683 44% Roles for Community Partners o In-Person Assister (IPA) Training and having an IPA certified through the Health Benefit Exchange (requires 25-30 hours of training & successfully passing the state certification exam.) o Hosting a location for a certified IPA to assist clients on a regularly scheduled basis. o Hosting a special event for a presentation / Q&A session and assistance. o Willingness to distribute Outreach & Assistance information .
    [Show full text]
  • Impactful Care: Addressing Social Determinants of Health Across Health Systems
    Portland State University PDXScholar Dissertations and Theses Dissertations and Theses Spring 6-5-2019 Impactful Care: Addressing Social Determinants of Health Across Health Systems Nicole Lisa Friedman Portland State University Follow this and additional works at: https://pdxscholar.library.pdx.edu/open_access_etds Part of the Anthropology Commons, and the Community Health Commons Let us know how access to this document benefits ou.y Recommended Citation Friedman, Nicole Lisa, "Impactful Care: Addressing Social Determinants of Health Across Health Systems" (2019). Dissertations and Theses. Paper 5073. https://doi.org/10.15760/etd.6957 This Thesis is brought to you for free and open access. It has been accepted for inclusion in Dissertations and Theses by an authorized administrator of PDXScholar. Please contact us if we can make this document more accessible: [email protected]. Impactful Care: Addressing Social Determinants of Health Across Health Systems by Nicole Lisa Friedman A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Anthropology Thesis Committee: Charles H. Klein, Chair Jeremy Spoon Matthew P. Banegas Portland State University 2019 i Abstract There is emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs. Unmet health-related social needs, such as food insecurity, inadequate or unstable housing, and lack of access to transportation may increase the risk of developing chronic conditions, reduce an individual’s ability to manage these conditions, increase health care costs, and lead to avoidable health care utilization. In response, work on social needs is happening across large health systems in the United States, but the pace of progress is slow and accountability is diffuse.
    [Show full text]
  • Hearing Summary March 6, 2019
    Hearing Summary March 6, 2019 E&C SUBCOMMITTEE ON HEALTH: LEGISLATION TO LOWER CONSUMER COSTS AND EXPAND ACCESS EXECUTIVE SUMMARY Members of the House Energy & Commerce Subcommittee on Health convened a hearing to discuss three bills intended to lower costs and improve access: H.R. 1425, the State Health Care Premium Reduction Act; H.R. 1386, the Expand Navigators Resources for Outreach, Learning and Longevity (ENROLL) Act; and H.R. 1385, the State Allowance for a Variety of Exchanges (SAVE) Act. Witnesses Peter Lee of Covered California and Ms. Audrey Morse Gasteier of Massachusetts Health Connector provided insight as to how successful state-based health insurance exchanges are organized and administered. Mr. J.P. Wieske from Wisconsin advocated for more innovative ways for patients to enroll in the health system through privatization and technology. Members were supportive of state reinsurance flexibility to lower premiums; however, Members were split on the effectiveness of patient navigators and the sustainability of state-based insurance markets. OPENING STATEMENTS Subcommittee Chairwoman Anna Eshoo (D-CA) began her opening statement by expressing support for the three proposed bills and restated Democrats’ commitment to lower costs for Americans. She asserted that the proposed bills bring down the cost of health insurance by allowing funding and flexibility to improve the individual market and increase choices, and added that reinsurance can be useful to account for those with preexisting conditions and to lower costs for middle class Americans. In his opening statement, Ranking Member Michael Burgess (R-TX) expressed his disappointment in the lack of bipartisanship on these bills, especially on the topic of reinsurance.
    [Show full text]
  • Establishing Patient/Health Navigator Programs for Education, Employment and Career Advancement
    Establishing Patient/Health Navigator Programs for Education, Employment and Career Advancement A California Community College Case Study August 2015 Prepared by the Career Ladders Project for Asian Americans for Community Involvement This publication was made possible by Grant Number 1C1CMS331035 from the Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of this publication are solely the responsibility of the authors and do INTRODUCTION The nation’s first Patient Navigator program was developed in 1990 for poor and underserved patients receiving treatment for cancer at the Harlem Hospital Center in New York City.1 Since then, hundreds of patient/health navigation programs have been established to meet a variety of patient needs in settings that include community clinics, outpatient and treatment centers, and schools. In all settings the patient/health navigator identifies, anticipates, and helps to alleviate barriers that patients encounter. Education and training of navigators has also taken place in a variety of settings. These include employers, training institutes2, community based organizations, extended education departments associated with colleges and universities3, and, to a lesser extent, community colleges. This report and its associated tools are intended for employers of patient/health navigators and community colleges as they partner to meet both workforce needs and training. Tools found in the Attachments of this report were primarily developed by an employer/educator Competency to Curriculum (C2C) workgroup and can be used to create either an entry level program for navigators or additional training in patient health navigation to an existing related program. Organizational Roles partnered with AACI to provide education and training for the project.
    [Show full text]
  • The Kentucky Colon Cancer Screening Program Advisory Committee Annual Report July 2013 Through June 2014
    The Kentucky Colon Cancer Screening Program Advisory Committee Annual Report July 2013 through June 2014 This report was prepared by The Kentucky Department for Public Health Division of Prevention and Quality Improvement Chronic Disease Prevention Branch in Collaboration with The Kentucky Colon Cancer Screening Program Advisory Committee The Kentucky Colon Cancer Screening Program Advisory Committee John M. Bennett, MD, MPH, Chair Deborah Armstrong, MSW, MPA, Co-Chair Primary Care, Veterans Administration Director, UK Kentucky Cancer Program Connie Sorrell, Co-Chair Stephanie Bates Director, UL Kentucky Cancer Program Kentucky Department of Medicaid Services Katie Bathje William F. Beam Director, Kentucky Cancer Consortium Colon Cancer Survivor Virginia Bradford, RN Shawn Crabtree Kentucky African Americans Against Cancer Director, Lake Cumberland District Health Dept. Kim Dees, RN, MSN, MBA/HCM Mark Evers, MD Kentucky Hospital Association Director, UK Markey Cancer Center Whitney Jones, MD Benjamin Lee Kessinger III Midwest Gastroenterology Associates, Kinkead & Stilz, PLLC Colon Cancer Prevention Project Donald M. Miller, MD, PhD James Sharp Director, UL Brown Cancer Center American Cancer Society Cancer Action Network Andrea Shepherd Thomas Tucker, PhD, MPH Director, Colon Cancer Prevention Project Director, Kentucky Cancer Registry Connie Gayle White, MD, MS, FACOG Deputy Commissioner of Clinical Affairs Kentucky Department for Public Health Representative Tom Burch Representative Rocky Adkins Senator Alice Forgy Kerr Kentucky Department
    [Show full text]
  • The Boston Medical Center Patient Navigation Toolkit
    The Boston Medical Center Patient Navigation Toolkit 1st Edition The Boston Medical Center Patient Navigation Toolkit PATIENT NAVIGATION AT BOSTON MEDICAL CENTER Since its inception in the year 2001, the AVON Breast Health Initiative at Boston Medical Center has provided breast health navigation services for more than 20,000 women, most of who are in low-income households and/or members of racial/ethnic minorities. Early on, we developed a model of patient navigation designed to ensure that vulnerable women receive timely diagnostic breast health services and demonstrated improvements in follow-up rates.1 We expanded that patient navigation model within the general medicine practices to include outreach to ensure timely adherence to routine screening mammography, and again showed an improvement in adherence rates.2 Our work revealed that women seeking care from local community health centers were less likely to attend follow up appointments than those referred from hospital-based practices. The Boston Medical Center Patient Navigation Research Program was funded in 2005 by the National Cancer Institute’s Center to Reduce Cancer Health Disparities and the American Cancer Society as one of nine programs to participate in the Patient Navigation Research Program (PNRP) Cooperative Group.3 The Boston PNRP developed a unique Community- Based Participatory Research Program, partnering with six Community Health Centers that serve a high proportion of Boston’s racial and ethnic minority and low income populations. These practices worked together to design, implement and evaluate a primary-care-based lay patient navigation program, targeting women with both breast and cervical cancer screening abnormalities. The Boston PNRP along with our CHC partners enrolled more than 4,000 women in the project.
    [Show full text]