Sample Research Paper on Patient Navigation Program Evaluation Report

Abstract

Patients often have a hard time accessing medical treatment; the process of diagnosing, planning treatment, accessing required assessments as well as recommendations in various clinical specialties is usually complex. Existing systems in health care often fail to appropriately handle patients’ needs in terms of information, care coordination and psychosocial needs. This leaves most of them to coordinate their health care needs with the assistance of their families only. Patient navigation eliminates these fragmentations by providing them with proper support in accessing medical needs. The patient navigation program evaluation is aimed at ensuring barriers to care are eliminated and the process of accessing care is simplified. Conducting consistent evaluations and monitoring of the strategies employed in providing quality services is significant in ensuring there is a further development of the program as well as increasing the learning experience of those involved in the program. Nurses involved in patient navigation program should evaluate their role in making an impact and improving the concepts that are applied in the specific programs.

Patient Navigation Program Evaluation Report
Type of health program

Patients especially those suffering from cancer often find it difficult accessing medical services due to their systemic complexities within the healthcare sector. These complexities have virtually clogged the healthcare system especially concerning service provision. Many cancer patients are unable to access the need for medical attention. This sometimes leads to avoidable deaths. This calls for a simpler program such as colorectal cancer (CRC) screening program that can help cancer patients to access life-changing treatments. The health program is aimed at reducing the burden of colorectal cancer on a specific group of people who are eligible for screening. Colorectal cancer or colon cancer is the third most common cancer and is more prevalent among those above the age of 50 years (Mandel et al., 2010). In the U.S, about 103, 170 cases of colon cancer were expected to be diagnosed in 2012, and an expectation of 51,690 deaths related to colorectal cancer in the same year. Normally beginning from rectal and colon polyps, colorectal cancer gradually becomes cancerous. Chances of curing colorectal cancer in its early stages are high therefore, it is very important to go for screening. In the earliest stage, no symptoms are observed but in the later stages abdominal discomforts, bleeding and change of bowel movements are likely to occur. The program, therefore, plays a key role in reducing incidences of colorectal cancer (Baxter et al., 2013).

Background Information

Michigan Colorectal cancer Early Detection program in Michigan, initiated in 2006 by the Michigan Department of Community Health, covers all the 38 counties in the state. It provides outreach, colorectal cancer education, personalized risk assessments and colorectal cancer screening. These services are provided to all residents of Michigan; however, the program also targets those communities at a higher risk (Battaglia, Burhansstipanov, Murrell & Dwyer, 2011).

This is because there are exists health disparities in colorectal cancer just like other cancers where its incidences is higher among African Americans compared to Caucasians in which case they are also more likely to die from colorectal cancer. Those eligible for the services under this program are both older men and women between the ages of 50-64 years, they should also fall under the low incomes levels of 250% of poverty levels or even less; those who are uninsured and the underinsured. MCRCEDP services are coordinated through eight local agencies. They also network with hospitals, physicians, and community healthcare organizations. Some of these partners include; Barry-Eaton District Health Department, Central Michigan Health Department; Muskegon County Health Department and Saint Mary’s Healthcare. The program has received a multi-year grant in year 2010 from the United State Centers for Disease Control and prevention to enable it to increase awareness of cancer and screening in Michigan (Battaglia et al., 2011).

Description of the program

Individual enrolled for MCRCEDP services are provided patient navigation from the initial point of referral to the end of screening. The appropriate time to start testing is established through consultations with a health care provider. In case of clients at an average risk of getting the cancer screening is done through Fecal occult Blood Test (FOBT) or sigmoidoscopy and for those at a high risk, screening is done through Colonoscopy or fecal immunochemical test (FIT). The program has managed to increase the rate of colorectal screening by a 40% rate higher than the national rate which is only 10%, this because the program incorporates patient education and barrier education to enhance the rates of patient screening (Hawley et al., 2012).

Barriers faced by patients include fear of taking the cancer test, financial problems such as lack of insurance and transportation problems, lack of knowledge, cultural conflicts or family and employment responsibilities. The program has come up with a number of interventions that increase the rate of screening unlike the lower rates when there are no interventions. These interventions have been implemented with the help of the health care workers who are well trained and culturally sensitive (Hawley et al., 2012). Navigators help to explain importance of procedures that are to be carried out and how patients should prepare for them. They also assist in alleviating fears by explaining what the patient should expect and answering their questions.

Other strategies that help to reduce barriers to colorectal cancer screening include conducting outreach through completion of screening; having collaborations with departments of health, health care facilities, and health care providers to make sure CRC screening is appropriately done and follow up services are provided. There are also collaborations with health care partners to change policies and systems in order to increase the screening of colorectal cancer. This is done through offering staff education, implementing reminder systems, and using chronic diseases registry as well as small campaigns in the media (Hawley et al., 2012).

Staff education is aimed at ensuring that patient navigators are well equipped with the necessary skills to be able to guide patients through the health care systems by helping them to access problems and establish relationships with health care provides. They also learn how to conduct internal as well as external outreach and assist in streamlining the program practices as well as tracking of inventions. They also acquire other skills such as computer skills, interpersonal communication skills, writing and language skills. They become familiar with the resources in the communities, hospital processes, structure, and function (Hawley et al., 2012).

 Results

The program has helped to increase access to care and services to individuals who are at a risk of colorectal cancer, the barriers to care such as financial, insurance and education have been significantly reduced and the level of customer satisfaction has been increased. The program also enhances training of program navigators who acquire a lot of experience in taking care of patients suffering from cancer and especially colorectal cancer from the screening stage to survivorship. The health care facilities involved in the program also has various benefits which include; better continuum of care as well as conditions for colorectal cancer patients, improvements in rates of colorectal cancer screening, better patient outcomes, receiving more referrals and increased support of the direct referrals (Battaglia et al. 2011).

Conclusion and Recommendations

The right to life and quality and timely medical services is provided for and protected by the constitution. However, many colorectal cancer patients find it increasingly difficult to access proper medication due to systemic complexities in the healthcare provision. Michigan Colorectal Cancer Early Detection program implementation has played a big role in ensuring that the rates of colorectal cancer incidences have reduced which had been on the rise since the year 1997. It has enhanced early detection of cancers as well as prevention to advance to the advanced stages saving lives and the costs involved in treating and taking care of advanced stages cancer. The program has especially been successful in assisting the older people in the communities who are at a higher risk as well as eliminating the health disparities between different ethnic communities such as the African Americans and Hispanics. The various interventions used in the program are significant in solving the communities’ major problems allowing easy access to health care. It also provides an opportunity for health care providers to increase their experience in providing care for colorectal cancer patients. It is recommendable that the program includes individuals belonging to other age groups which will increase the scope of people screened. Education should also be introduced to patients as well as navigators on how colorectal cancer should be prevented or on the means that can be used to reduce the chances of getting colorectal cancer.

References

Battaglia, T. A., Burhansstipanov, L., Murrell, S. S. & Dwyer, A. J. (2011). Assessing the impact of patient navigation. Cancer117(S15), 3551-3562.

Baxter, N. N., Virnig, D. J., Rothenberger, D. A., Morris, A. M., Jessurun, J., & Virnig, B. A. (2013). Lymph node evaluation in colorectal cancer patients: a population-based study. Journal of the National Cancer Institute97(3), 219-225.

Hawley, S. T., Volk, R. J., Krishnamurthy, P., Jibaja-Weiss, M., Vernon, S. W., & Kneuper, S. (2012). Preferences for colorectal cancer screening among racially/ethnically diverse primary care patients. Medical care46(9), S10-S16.

Mandel, J. S., Bond, J. H., Church, T. R., Snover, D. C., Bradley, G. M., Schuman, L. M., & Ederer, F. (2010). Reducing mortality from colorectal cancer by screening for fecal occult blood. New England Journal of Medicine328(19), 1365-1371.