What is a Breast Health Navigator?

A nurse who is proficiently knowledgeable about breast diseases.
A provider of educational information and support to all women concerned about their breast health.
An educational and emotional consultant for women with benign breast diseases.
A supporter of the breast cancer patient and her family in understanding and coping with the strong emotions that accompany a breast cancer diagnosis. She remains a constant caregiver and overseer of the patient’s educational, emotional and social needs.
A provider of educational resources for the patient and her family to answer their questions and address their fears during the breast cancer experience.
A facilitator of physicians’ recommendations for patient care to help ensure patient compliance and understanding.
A nurse educator that provides the facts—not opinions and not treatment advice, which is the role of the physicians. She explains advantages and disadvantages and leaves final decisions to the patient and her physician. She supports their decisions as being the right ones for them.
A triage manager in assessing patients’ educational and social needs identifying healthcare barriers and appropriately referring to the proper source of help.
A group leader and facilitator of support groups for patients, their support partners and children.
A nurse educator for other medical personnel in understanding benign and malignant diseases, their treatment and the patient’s emotional and social recovery from the disease.
A public educator on the early detection of breast disease and breast self-exam skills.
A public advocate for the needs of breast cancer patients and their families.
A researcher of the latest information on changes in breast health and breast cancer care to help keep staff and physicians up-to-date.

Summary of Breast Health Navigator Role

Provide education and support for the patient and family
Assess to identify high-risk patients (physical, psychological and social), identify any healthcare barriers and provide early triage or intervention
Plan healthcare pathways with multidisciplinary care team
Coordinate care with other team members
Monitor patient’s total response to care for optimum outcomes

Goals of Breast Health Navigator

Develop a care plan that addresses and removes healthcare barriers and meets the needs and expectations of both the patient and physicians
Enhance the patient’s quality of life, sense of autonomy and self-determination for managing her own health
Teach patient and family members self-care capabilities and skills to adjust to an altered state of health
Promote an interactive relationship that keeps communications open among patient, family, nurse and physicians
Monitor for symptoms of exacerbation of disease or maladaptation to illness
Provide early intervention and appropriate access to healthcare services
Manage services throughout the continuum of care, decreasing fragmentation of care

The Breast Health Navigator

The role of the Breast Health Navigator evolved to meet the changing demands of managed healthcare and reimbursement issues. In the 1990s, as healthcare moved patients to outpatient care to control costs, it greatly changed the contact and time spent with professional healthcare providers. Physicians and nurses had limited time to instruct and support the patient after a diagnosis. This decrease in time created problems in teaching self-care skills, providing anticipatory guidance and for triage to ancillary services when needed. As a result, huge gaps occurred in the quality-of-life issues for patients as they struggled to learn how to care for themselves in the home environment.

A breast cancer diagnosis has many clinical and service challenges. A diagnosis affects both the physical and mental well-being of the patient. It alters her self-esteem, body image and sexuality. The complexity of the issues—focus on patient teaching along with social and emotional support, pursuit for better clinical quality and the arrival of new treatment modalities—required a trained nurse case manager with the ability to increase patient outcomes and patient satisfaction while containing costs. Thus, in the early 1990s, healthcare created the role of the Breast Health Navigator to meet the complexities of breast cancer outpatient management.

Defining the Role of the Breast Health Navigator

No matter what the title, the chain of command or the number of procedures performed daily, there is a commonality among nurses who care for women with breast health concerns. She addresses both the art and the science of breast healthcare and redefines the patient’s experience.

Why is a Breast Health Specialist/Navigator Valuable?

Manages the challenge of cost reduction, a pivotal driving force in healthcare
Acknowledges cost-restraint mandates, such as early discharge from hospitals, by enabling patient with resources and empowering her with understanding of her care process
Empowers patients to work as a partner with the healthcare team through education on understanding medical procedures and terms, reducing time constraints on physicians
Provides patient self-care skills teaching to enhance their quality-of-life in response to reduced access to professional healthcare providers
Addresses patients’ unmet needs and enhances patients’ satisfaction by responding to their most frequent request—information and support during illness
Provides professional guidance in coordination, execution and evaluation of their healthcare treatment plans.

How the Breast Health Specialist/Navigator Expedites
Her Role

The Breast Health Navigator serves as a consistent care coordinator throughout the continuum of care assessing the healthcare barriers and the physical, psychological, and social needs of the patient. She provides the patient with educational, emotional and social support. The assessment is relayed to a multidisciplinary team to collaboratively design a care plan with desired outcomes. The Breast Health Navigator focuses on achieving the healthcare outcomes within effective and realistic time frames. She monitors the patient and triages needed services across all product or service lines while removing barriers and ensuring proper access to these services. In addition, she extends services to help the family learn care-giving skills and patient self-care skills. Teaching the patient and family self-care skills, including physical and psychological, reduces acute annoyances, costly hospitalizations and inappropriate medical care access. The results are enhanced patient outcomes, increased satisfaction and reduced costs of care.

Knowledge and Skills Required for Breast Health Specialist/Navigator

Demonstrated use of clinical skills and expertise in the area of breast disease, breast cancer treatments and psychosocial impact of disease on recovery
Ability to comprehensively assess patient’s physical and psychosocial status
Ability to effectively and efficiently coordinate, implement and monitor the care management process and treatment plan for each patient
Ability to communicate openly and empathetically with patients and families
Ability to work collaboratively with multidisciplinary care team to develop and implement care plan
Ability to develop and implement in-house (professional development) and community education outreach programs/workshops/seminars/support services
Ability to communicate effectively with diverse audiences including professional staff, patients, community, media, and other service agencies
Knowledge of adult learning competencies and patient teaching skills
Demonstrated management skills reflecting self-motivation, initiative and fiscal responsibility
Tolerance of ambiguity and the flexibility to respond to changing system needs