Cancer care is fragmented, requiring cancer patients to receive services from multiple facilities as well as within diverse departments and centers of the cancer facility. Patient Navigators provide continuity to overcome such fragmentation. A Native Patient Navigator (NPN) is a trusted member of the local American Indian / Alaska Native (AI/AN) community who is trained to work directly with individuals to facilitate timely access to healthcare by eliminating or navigating barriers that may impede care. NPNs begin by providing outreach and education but continue providing support throughout the cancer continuum (outreach and education through end-of-life). Their work usually begins working with an individual in the community but continues as they cross the threshold of the clinic to work with the patient and other members of the healthcare team in the clinical setting. Although NPNs provide support and help throughout the cancer continuum, they do NOT provide medical advice. Native American Cancer Research Corporation (NACR) initiated the first AI NPN program in 1994 and has been conducting NPN training since 1995.
A cancer patient navigator is an individual trained to help identify and resolve real and perceived barriers to care, enabling patients to adhere to care recommendations and thus improve their cancer outcomes.
The attachments below list Patient Navigator competencies from different organizations / sources. None fit every Patient Navigation program's needs (i.e., no one size fits everyone) and Patient Navigation programs need to select the competencies that are the best match for their local program.
Examples of Toolkits to assist Patient Navigators are on the Resources Page
In 1999, the Institute of Medicine recommended that quality care is measured using a core set of metrics. The Academy of Oncology Nurse and Patient Navigators (AONN+) identified ~36 core competencies in 2017 that subsequently have been supported by national organizations, including but not limited to the:
These metrics are being used to evaluate whether patient navigation can improve outreach throughout end-of-life and overall value in healthcare. They also are being used as criteria for patient navigation accreditation certification and programs.
Patient /Participants Characteristics
Diagnosis & Treatments
Institute of Medicine and National Research Council. Ensuring Quality Cancer Care. Washington, DC: National Academies Press. 1999. https://doi.org/10.17226/6467 accessed August 26, 2020
The Patient Navigator continues working with the patient from community interactions through the door of the clinical setting and in collaboration with members of the health care team within the clinic.
Community or Lay Patient Navigator
Licensed Nurse or Social Work Navigator
Peer Educator or Advisor
Promotores de Salud
Lay Health Advisor
Community Health Worker