Lessons Learned from the Implementation of a Patient Navigation Program at Community Hospitals

Funded by the Pennsylvania Department of Health, this demonstration project evaluated a theory-guided patient navigation program implemented at an urban-minority community hospital and a rural community hospital. This presentation will summarize the challenges and barriers of implementing the patient navigation program.

At the end of the study, semi-structured interviews were conducted with navigators, administrative managers, and research staff to seek their experience with the navigation program. We coded and analyzed the interview transcripts by using qualitative methods to explore the challenges and barriers of conducting and implementing the navigation program at community hospitals.

Emerging themes were grouped into five categories: operation, communication, study recruitment, training and support, and management. One of the operational challenges was that referral procedure was not systematically set up. Maintaining open lines of communication to promote understanding and awareness between research team and navigation sites was found important. The consenting process was reported as a significant barrier for study recruitment. Initial and ongoing training of the navigators was found to be of great importance.

Implementing a navigation program in community hospitals is challenging but feasible. We found out that recruitment was difficult both due to a reduction of patient population and both patient and staff's reluctance to participate in research. A considerable amount of time and communication processes were also required between research site and hospital sites. Interview findings highlight the importance of supporting organizations to conduct internal assessments to address potential barriers and obstacles in order to facilitating the implementation of the navigation program.