Patient Navigation History
This page provides a brief history of the UNC Cancer Network’s Patient Navigation Program and how it has evolved since its inception.
In an effort to better serve the needs of the North Carolinian cancer patients and their caregivers, UNC Lineberger Comprehensive Cancer Center identified a number of clinical, education, research and survivorship goals in 2007. Careful consideration was given to ensure our outreach efforts extended the entire state. The program goals were to save lives, eliminate barriers to quality care and ensure speedy delivery of appropriate services.
As a result, three different models of patient navigation using clinical and non-clinical navigators were developed at the following sites:
- Mission Health System in Asheville, NC (Thoracic Nurse Navigation)
- Vidant Medical Center at East Carolina University in Greenville (GI;Head/Neck Nurse Navigation)
- Dare County, located on North Carolina’s Outer Banks, in collaboration with the Outer Banks Hospital (Nurse and Lay Navigation)
Our ability to partner with the academic institution as well as the community cancer hospitals/centers have been identified as an essential component of the success of this program. Our programs have demonstrated the importance of having both professional and lay navigators working in tandem. Nurse Navigators have been shown to have a significant impact in improving the quality of treatment of patients with cancer. Equally as important is the non-clinical support that patients require. We have found a unique role for lay patient navigators to work in tandem with the medical team, helping to identify non-clinical barriers to care and connect patients with available local, state and national resources.
Lay Patient Navigation
With the initial launch of the nurse navigation model in Dare County, many challenges continued and new challenges emerged. The number of new patients escalated. The percentage of uninsured and underinsured patients continued to pose problems. Local geography made it difficult for the two nurse navigators to reach some townships, especially in isolated areas. In 2009, UNC developed a model of lay navigation that included the development of a standardized training curriculum and process for vetting volunteers. By partnering with the volunteer program at UNC Health Care, a program was piloted at a rural hospital in Eastern North Carolina and trained over 45 volunteers as lay navigators. Integrated into the cancer clinic and community, they demonstrated their ability to identify and overcome barriers to care while linking patients to available cancer support resources. In 2014, the model was adapted for inclusion into the clinics and inpatient setting of the NC Cancer Hospital in Chapel Hill. As a result, trained volunteers have demonstrated their ability to identify and acquire critical resources patients’ needs when faced with inadequate financial resources, lack of transportation or lack of social support. Today, over 150 lay patient navigators have been trained. They are retired health care professionals, pre-med students, members from the business community, cancer survivors, caregivers and pre-med students. Lay navigators are integrated in both the outpatient clinics and inpatient units of the NC Cancer Hospital.
In 2017, the Advisory Board Company identified the UNC LCCC model of lay patient navigation as one of three best practices in the US. Funding was received in 2017 from The Duke Endowment to expand this model to 11 sites in North Carolina. Sites included: Carteret Health Care (Morehead City), Caldwell UNC Health Care (Lenoir), CarolinaEast Cancer Center (New Bern), Duke Cancer Institute (Durham), Mission Cancer Center (Asheville), Nash Health Care (Rocky Mount), Pardee Hospital (Hendersonville), Seby B. Jones Cancer Center (Boone), UNC Lenoir Health Care (Kinston), Vidant Medical Center (Greenville), and Zimmer Cancer Center (Wilmington).