Supportive Care in Cancer

, Volume 27, Issue 12, pp 4497–4505 | Cite as

Promoting assessment and management of function through navigation: opportunities to bridge oncology and rehabilitation systems of care

  • Nicole L. StoutEmail author
  • Alix Sleight
  • Denise Pfeiffer
  • Mary Lou Galantino
  • Bianca deSouza
Original Article


Recent calls from oncology providers and cancer policy forums advocate for improved connections between rehabilitation services and cancer care delivery. Traditionally, this intersection has occurred when patients present with overt disability related to cancer treatment and is driven by reactive approaches to care. A growing body of evidence suggests that a proactive approach to functional screening and assessment encourages the identification and management of functional impairment and morbidity earlier in the cancer care continuum and contributes to better outcomes. A clinical pathway that prompts screening and referral to rehabilitation services in an expedited manner is needed. Cancer patient navigators provide care coordination through the duration of medical treatment, survivorship, and end-of-life. This article presents a framework for navigation workflows to support functional assessment and provide early triage pathways to the rehabilitation system of care. We provide a case example of novel approach to patient navigation from a Southeastern United States community cancer center that uses a patient navigator with a rehabilitation background to serve in this role. An overview of the position skills, functional assessment and referral pathways, and perspective on quality improvements related to this approach are described. The use of rehabilitation providers beyond traditional clinical roles should be further explored. Their expertise in functional assessment and interpretation could foster improvements in cancer care delivery and outcomes for survivors in both the short and long term.


Patient navigation Rehabilitation Function Functional morbidity Functional assessment Care coordination 


Compliance with ethical standards


The opinions expressed in this article are the authors’ own and do not reflect the view of the National Cancer Institute, the National Institutes of Health, the Department of Health and Human Services, or the US government.

Conflict of interest

The authors have full control of all primary data and agree to allow the journal to review the data if requested.


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Copyright information

© This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply  2019

Authors and Affiliations

  1. 1.Rehabilitation Medicine DepartmentNational Institutes of HealthBethesdaUSA
  2. 2.Division of Cancer Control and Population SciencesNational Cancer InstituteRockvilleUSA
  3. 3.Lee Health SystemFort MyersUSA
  4. 4.School of Health SciencesStockton UniversityGallowayUSA
  5. 5.School of Medicine, Center for Biostatistics and EpidemiologyUniversity of PennsylvaniaPhiladelphiaUSA
  6. 6.Department of PhysiotherapyUniversity of WitwatersrandJohannesburgSouth Africa

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