Implementing patient navigation to increase colonoscopy screening in New York City

In 2003, only 42% of New York City residents over age 50 reported having had a colonoscopy within the past ten years. To address these low screening rates, patient navigators were introduced in three public hospitals serving a large volume of patients. An innovative initiative, navigators guide patients who are receiving colonoscopies through the health care system by assisting them with access issues, connecting them with hospital personnel, and tracking interventions and outcomes. Key activities by the navigators include scheduling, patient education, and follow-up. A prior evaluation of the program showed that introduction of navigators contributed to statistically significant increases in colonoscopy screening and substantial decreases in broken appointment rates and procedure wait times. To better understand the success of the navigators and enhance this intervention, a recent qualitative study interviewed patients, providers, hospital staff and navigators. Findings highlighted that virtually all patients described a positive experience with patient navigators and the majority responded that they needed the navigator to complete their colonoscopy. Results demonstrated that providers and staff viewed navigators as well-embedded in the hospital system and critical for assuring patients keep appointments. Patient navigators participated in the evaluation and documentation through individual interviews, critical organization of patient and provider interviews, and timely monthly reporting. These findings will guide the expansion of the navigator program to additional hospitals and help further develop evaluation methods and criteria. A joint presentation by a navigator and program staff will explain the impact of this initiative and best practices to achieve these results.