Supportive Care in Cancer

, Volume 27, Issue 11, pp 4359–4362 | Cite as

Patient navigation for complex care patients in the emergency department: a survey of oncology patient navigators

  • Jason J. BischofEmail author
  • Jean B. Sellers
  • Andrew W. Phillips
  • James J. Petrongelli
  • Amy E. Stuckey
  • Timothy F. Platts-Mills
Original Article



Emergency departments (EDs) care for patients with complex medical problems who require a coordinated care approach. Patient navigation services, which help assist patients with care coordination, have been widely implemented for patients with cancer in a variety of settings, but this approach has not been described in the ED. We sought to better understand the potential for ED-based patient navigation services from the perspective of individuals currently providing these services in other settings.


A survey was conducted of participants at a regional conference for patient navigation services of patients with cancer.


Eighty-five completed surveys were returned representing a response rate of 64%. Ninety-one percent of responses indicated that lay navigation services would be either very helpful or moderately helpful for either ED patients with cancer or for ED patients aged 65 years or older with or without cancer in an ED. Coordination of care, the provision of emotional support and educational resources relevant to their medical conditions, and providing companionship to older patients during the ED visits were identified as priorities for an ED-based lay navigation program. The lack of navigators with experience in the ED, the physical space constraints of the ED, and the time constraints associated with an ED visit were identified as the primary barriers to establishing a lay navigation program in the ED.


These results identify the care priorities and barriers to be overcome during the development of an ED-based lay navigation program from the perspective of those currently providing patient navigator services.


Emergency department Care coordination Lay navigation Oncology navigator 


Author contributions

Study concept and design: all authors; Acquisition of the data: JJB; Analysis and interpretation of the data: JJB, JBS, TFP; Drafting of the manuscript: JJB, TFP; Critical revision of the manuscript: all authors.

Compliance with ethical standards

Conflict of interest

JJB, AES, AWP, JP, and TFP report no conflict of interest. JBS reports paid participation in a speaker’s bureau for Novartis and Pfizer. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

Supplementary material

520_2019_4766_MOESM1_ESM.pdf (183 kb)
ESM 1 (PDF 183 kb)


  1. 1.
    Rivera DR, Brown J, Shelburne N (2018) Questions about emergency department treatment of patients with solid tumors and hematological malignant neoplasms-reply. JAMA Oncol 4:750–751CrossRefGoogle Scholar
  2. 2.
    Statistics NCfH (2015) National Hospital Ambulatory Medical Survey: 2015 Emergency Department Summary Tables. Book National Hospital Ambulatory Medical Survey: 2015 Emergency Department Summary Tables, CityGoogle Scholar
  3. 3.
    Hedlund N, Risendal BC, Pauls H, Valverde PA, Whitley E, Esparza A, Stiehl E, Calhoun E (2014) Dissemination of patient navigation programs across the United States. J Public Health Manag Pract 20:E15–E24CrossRefGoogle Scholar
  4. 4.
    Paskett ED, Harrop JP, Wells KJ (2011) Patient navigation: an update on the state of the science. CA Cancer J Clin 61:237–249CrossRefGoogle Scholar
  5. 5.
    Baileys K, McMullen L, Lubejko B, Christensen D, Haylock PJ, Rose T, Sellers J, Srdanovic D (2018) Nurse navigator core competencies: an update to reflect the evolution of the role. Clin J Oncol Nurs 22:272–281CrossRefGoogle Scholar
  6. 6.
    Carter N, Valaitis RK, Lam A, Feather J, Nicholl J, Cleghorn L (2018) Navigation delivery models and roles of navigators in primary care: a scoping literature review. BMC Health Serv Res 18:96CrossRefGoogle Scholar
  7. 7.
    Rocque GB, Pisu M, Jackson BE, Kvale EA, Demark-Wahnefried W, Martin MY, Meneses K, Li Y, Taylor RA, Acemgil A, Williams CP, Lisovicz N, Fouad M, Kenzik KM, Partridge EE, Group PCC (2017) Resource use and Medicare costs during lay navigation for geriatric patients with cancer. JAMA Oncol 3:817–825CrossRefGoogle Scholar
  8. 8.
    Tan CH, Wilson S, McConigley R (2015) Experiences of cancer patients in a patient navigation program: a qualitative systematic review. JBI Database System Rev Implement Rep 13:136–168CrossRefGoogle Scholar
  9. 9.
    Society ON, Work AoOS, Workers NAoS (2010) Oncology Nursing Society, the Association of Oncology Social Work, and the National Association of Social Workers joint position on the role of oncology nursing and oncology social work in patient navigation. Oncol Nurs Forum 37:251–252Google Scholar
  10. 10.
    Meade CD, Wells KJ, Arevalo M, Calcano ER, Rivera M, Sarmiento Y, Freeman HP, Roetzheim RG (2014) Lay navigator model for impacting cancer health disparities. J Cancer Educ 29:449–457CrossRefGoogle Scholar
  11. 11.
    Artino AR, La Rochelle JS, Dezee KJ, Gehlbach H (2014) Developing questionnaires for educational research: AMEE Guide No. 87. Med Teach 36:463–474CrossRefGoogle Scholar
  12. 12.
    Rocque GB, Partridge EE, Pisu M, Martin MY, Demark-Wahnefried W, Acemgil A, Kenzik K, Kvale EA, Meneses K, Li X, Li Y, Halilova KI, Jackson BE, Chambless C, Lisovicz N, Fouad M, Taylor RA (2016) The patient care connect program: transforming health care through lay navigation. J Oncol Pract 12:e633–e642CrossRefGoogle Scholar
  13. 13.
    Ustjanauskas AE, Bredice M, Nuhaily S, Kath L, Wells KJ (2016) Training in patient navigation: a review of the research literature. Health Promot Pract 17:373–381CrossRefGoogle Scholar
  14. 14.
    Yang Z, Yang R, Kwak MJ, Qdaisat A, Lin J, Begley CE, Reyes-Gibby CC, Yeung SJ (2018) Oncologic emergencies in a cancer center emergency department and in general emergency departments countywide and nationwide. PLoS One 13:e0191658CrossRefGoogle Scholar
  15. 15.
    Spencer JC, Samuel CA, Rosenstein DL, Reeder-Hayes KE, Manning ML, Sellers JB, Wheeler SB (2018) Oncology navigators’ perceptions of cancer-related financial burden and financial assistance resources. Support Care Cancer 26:1315–1321CrossRefGoogle Scholar
  16. 16.
    Chang BP, Gallos G, Wasson L, Edmondson D (2018) The unique environmental influences of acute care settings on patient and physician well-being: a call to action. J Emerg Med 54:e19–e21CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Emergency MedicineUniversity of North Carolina School of MedicineChapel HillUSA
  2. 2.Department of Emergency MedicineThe Ohio State University Wexner Medical CenterColumbusUSA
  3. 3.Lineberger Comprehensive Cancer CenterUniversity of North Carolina at Chapel HillChapel HillUSA
  4. 4.Department of Care ManagementUniversity of North Carolina HospitalsChapel HillUSA

Personalised recommendations