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Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany

BACKGROUND: The concept of patient navigation was first established in the USA to support vulnerable patient groups in receiving timely and comprehensive access to cancer care. It has recently gained increasing interest in Germany to support patients with chronic diseases in a fragmented healthcare...

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Autores principales: Gödde, Kathrin, Fügemann, Hella, Desch, Anke, Stumm, Judith, Schindel, Daniel, Rieckmann, Nina, Meisel, Andreas, Müller-Nordhorn, Jacqueline, Goerling, Ute, Holmberg, Christine
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202203/
https://www.ncbi.nlm.nih.gov/pubmed/35710375
http://dx.doi.org/10.1186/s12913-022-08063-6
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author Gödde, Kathrin
Fügemann, Hella
Desch, Anke
Stumm, Judith
Schindel, Daniel
Rieckmann, Nina
Meisel, Andreas
Müller-Nordhorn, Jacqueline
Goerling, Ute
Holmberg, Christine
author_facet Gödde, Kathrin
Fügemann, Hella
Desch, Anke
Stumm, Judith
Schindel, Daniel
Rieckmann, Nina
Meisel, Andreas
Müller-Nordhorn, Jacqueline
Goerling, Ute
Holmberg, Christine
author_sort Gödde, Kathrin
collection PubMed
description BACKGROUND: The concept of patient navigation was first established in the USA to support vulnerable patient groups in receiving timely and comprehensive access to cancer care. It has recently gained increasing interest in Germany to support patients with chronic diseases in a fragmented healthcare system. The aim of this paper is to present the development of such a model adapted to the German context based on the results of mixed-methods studies investigating the need for and barriers to patient-oriented care. METHODS: In a process adapted from Delphi rounds, we conducted regular structured workshops with investigators of the project to discuss results of their studies and identify content and structure of the model based on the data. Workshop discussions were structured along seven core components of a navigation model including target patient groups, navigator tasks, occupational background and education of navigators, and patient-navigator interaction mode. RESULTS: Using an approach based on empirical data of current care practices with special focus on patients’ perspectives, we developed a patient-oriented navigation model for patients who have experienced stroke and lung cancer in the German healthcare context. Patients without personal social support were viewed as struggling most with the healthcare system, as well as multimorbid and elderly patients. Navigators should serve as a longer-term contact person with a flexible contact mode and timing based on the individual situation and preferences of patients. Navigator tasks include the provision of administrative and organizational support as well as referral and guidance to available resources and beneficial health programs with special forms of knowledge. Implementation of the navigator should be flexibly located to ensure a reliable outreach to vulnerable patients for first contact in settings like specialized in-patient and out-patient settings, while navigation itself focuses on care coordination in the out-patient setting. CONCLUSION: Flexibility of navigator tasks needed to be a core characteristic of a navigation model to be perceived as supportive from patients’ perspectives. In a subsequent feasibility study, an intervention based on the model will be evaluated according to its acceptance, demand, and practicality.
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spelling pubmed-92022032022-06-17 Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany Gödde, Kathrin Fügemann, Hella Desch, Anke Stumm, Judith Schindel, Daniel Rieckmann, Nina Meisel, Andreas Müller-Nordhorn, Jacqueline Goerling, Ute Holmberg, Christine BMC Health Serv Res Research BACKGROUND: The concept of patient navigation was first established in the USA to support vulnerable patient groups in receiving timely and comprehensive access to cancer care. It has recently gained increasing interest in Germany to support patients with chronic diseases in a fragmented healthcare system. The aim of this paper is to present the development of such a model adapted to the German context based on the results of mixed-methods studies investigating the need for and barriers to patient-oriented care. METHODS: In a process adapted from Delphi rounds, we conducted regular structured workshops with investigators of the project to discuss results of their studies and identify content and structure of the model based on the data. Workshop discussions were structured along seven core components of a navigation model including target patient groups, navigator tasks, occupational background and education of navigators, and patient-navigator interaction mode. RESULTS: Using an approach based on empirical data of current care practices with special focus on patients’ perspectives, we developed a patient-oriented navigation model for patients who have experienced stroke and lung cancer in the German healthcare context. Patients without personal social support were viewed as struggling most with the healthcare system, as well as multimorbid and elderly patients. Navigators should serve as a longer-term contact person with a flexible contact mode and timing based on the individual situation and preferences of patients. Navigator tasks include the provision of administrative and organizational support as well as referral and guidance to available resources and beneficial health programs with special forms of knowledge. Implementation of the navigator should be flexibly located to ensure a reliable outreach to vulnerable patients for first contact in settings like specialized in-patient and out-patient settings, while navigation itself focuses on care coordination in the out-patient setting. CONCLUSION: Flexibility of navigator tasks needed to be a core characteristic of a navigation model to be perceived as supportive from patients’ perspectives. In a subsequent feasibility study, an intervention based on the model will be evaluated according to its acceptance, demand, and practicality. BioMed Central 2022-06-16 /pmc/articles/PMC9202203/ /pubmed/35710375 http://dx.doi.org/10.1186/s12913-022-08063-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Gödde, Kathrin
Fügemann, Hella
Desch, Anke
Stumm, Judith
Schindel, Daniel
Rieckmann, Nina
Meisel, Andreas
Müller-Nordhorn, Jacqueline
Goerling, Ute
Holmberg, Christine
Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
title Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
title_full Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
title_fullStr Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
title_full_unstemmed Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
title_short Development of a patient-oriented navigation model for patients with lung cancer and stroke in Germany
title_sort development of a patient-oriented navigation model for patients with lung cancer and stroke in germany
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9202203/
https://www.ncbi.nlm.nih.gov/pubmed/35710375
http://dx.doi.org/10.1186/s12913-022-08063-6
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