Navigating the Health System It Takes More Than Breadcrumbs…to get through the maze
The concept of patient navigation has emerged as a way of characterizing the experiences of consumers in health care….patient navigation is defined as “the process(es) by which patients and/or their health caregivers move into and through the multiple parts of the health care enterprise in order to gain access to and use its services in a manner that maximizes the likelihood of gaining the positive health outcomes available through those services.” This term began with cancer treatment to that those with cancer would have a partner, often a nurse, to help them through the many phases of treatment. This concept has grown to other areas of care.
Given the highly fractured …nature of the U.S. health care sector, this process is fraught with challenges for most consumers, …especially those who are sick, stressed, busy with their everyday lives or otherwise disadvantaged in taking on the tasks involved.
For patients to get timely, appropriate,affordable and quality care, they must be able to navigate the health care system.When it is too burdensome, patients and their caregivers respond by delaying or failing to get needed care or by seeking care in inappropriate but more easily accessible settings, such as emergency departments.Navigation challenges may also inhibit the capacity of certain individuals more than others, which can exacerbate health disparities.This leaves many vulnerable to the clinical consequences of poorly navigated health care.
Currently the patient navigation model has been expanded to include the timely movement of an individual across the entire health care continuum from prevention, detection, diagnosis, treatment, and supportive, to end-of-life care. Not every patient will have or needs a specified navigator, but all patients need to have coordinated care.
Vicki D. Lachman, PhD, APRN, MBE, FAAN
Clinical Professor emeriti
Director, Innovation and Intra/Entrepreneurship in Advanced Practice Nursing
Drexel University College of Nursing and Health Professions
Arlene D. Houldin, PhD, PMHCNS-BC, ACHPN
Executive Director, HEAL (Holistic Enrichment of Adult Living)
Associate Professor Emerita of Psychosocial Nursing-School of Nursing. University of Pennsylvania, Philadelphia, PA