She had ovarian cancer, and she wanted answers. The answers she wanted, though, lay beyond those found in a medical journal.
The 61-year-old woman arrived at City of Hope to consult her physician and have an imaging scan. A more immediate issue, though, was the pain that wracked her body — and the fear that accompanied it.
Fortunately, City of Hope’s corps of patient navigators quickly recognized her distress and responded. They consulted with physicians specializing in pain, got her a private room, stayed with her and calmed her with relaxation exercises. Throughout the woman’s treatment, the navigators set up family meetings to ease communication between family members and physicians, taught her about pain management, informed her about advanced directives and, ultimately, after her death, helped her family grieve.
Through a pilot program, patient navigators provide personalized guidance, support and assistance to enhance patients’ experiences at City of Hope. They form a key part of the services provided through the Sheri & Les Biller Patient and Family Resource Center.
“Navigators serve as connective tissue for the medical center,” said Annette Mercurio, M.P.H., C.H.E.S., director of programs for the center and head of the navigator program. “They are proactive and prevent crises before they happen. They enhance continuity of care and make it easier for members of the healthcare team to work together.”
Three types of navigators work together under the center’s umbrella: services navigators, patient and family support navigators and systems navigators.
First, services navigators personally guide each patient to City of Hope’s resources and provide tailored education, practical information and support. Services navigator Terry Hernandez sees each patient upon their second visit; she already has seen more than 800 patients since the program started in March 2007.
Services navigator Jeanne Lawrence helps patients learn more about community resources and managing disease symptoms through informational materials.
Next, patient and family support navigators assess patients to determine what support services they need. They might want to see a chaplain, for example, or they may need to learn skills to better communicate with a spouse or children about illness.
These navigators include Heather Ducksworth, M.S.W., and Carolyn Stoutt, M.S.W.
Finally, in systems navigation, team members gather lessons from other navigators’ experiences and patient feedback and use them to improve City of Hope’s systems and processes. Karen Clark and Mercurio currently lead the systems navigation effort.
Navigators are currently refining their program in the clinics of three oncologists: Ellie Maghami, M.D., Robert Morgan, M.D., and Joanne Mortimer, M.D.
“As a physician, I can focus on the patient’s therapy and answering questions related to cancer treatment without being distracted by psychosocial problems that I am not competent to resolve,” Mortimer said.
“The patient navigator program clearly enhances not only the quality of life of the patient and family, but that of the physician and nurse as well.”
Navigators are testing an easy-to-complete survey that will help them quickly understand new patients’ needs. The navigators and other team members plan to spread the program throughout the medical center as the program is refined.
For more information about patient navigation, please contact Mercurio at ext. 64888 or amercurio@coh.org.
