Origins of Navigation

Patient navigation began in the early 1990s as a way to facilitate better care for underserved populations. During its inception, the navigators were often not nurses but laypeople or social workers. In 2009, The Oncology Nurse Society, the Association of Oncology Social Work and the National Association of Social Workers redefined the field of nurse navigation as the “individualized assistance offered to patients, families and caregivers to help overcome health system barriers and facilitate timely access to quality health and psychosocial care from prediagnosis through all phases of the cancer experience. Navigation has come a long way in a fairly short time but is still difficult to define because navigation is different in every area it is practiced.

There are two different types of navigation. The first is barrier focused navigation, which looks at changes in access to care. By tracking and reporting common barriers to care, the navigator then finds strategies to resolve or reduce the issues keeping patients from getting their best care. The other type of navigation is service focused navigation. Service focused aims at finding and coordinating services to patients and families and making sure they are given the needed education and care. Tracking barriers and arranging care and education for the patients seem to run together into one role for most navigators. ONS recorded some of the major challenges in navigation at this time are accurately measuring and ensuring “desired and optimal outcomes” for all involved in the cancer process, including families and survivors. Research is still being done, including the National Patient Navigation Research Program, to measure the best way to track patients care and ensure them the best quality cancer care they can receive.

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