Washington, DC, patient navigation effort seeks to improve disparities


  • Carrie Printz

Washington, DC, has some of the worst cancer statistics in the country, according to Steve Patierno, PhD, executive director of the George Washington University Cancer Institute (GWCI) in Washington, DC. “We're an acute microcosm of the national, unequal burden of cancer,” he says.

When Dr. Patierno became director of the institute in 2003, he helped create a cancer-control coalition of citywide stake holders including hospitals, cancer centers, and community-based organizations to address disparities. The institute also hired 4 full-time cancer outreach specialists who were deployed into the community to launch educational interventions.

“We created congregational, neighborhood, and workplace outreach initiatives,” he says. “And we sentworkers out into churches, barbershops, beauty salons, and fraternal organizations, starting the process of raising awareness and building trust.”

In addition, GWCI also began to track cancer incidence in each city neighborhood to understand where the concentrations of disease were and which areas needed to be targeted.

As part of improving disparities in these areas, GWCI is 1 of 9 centers across the country to receive a grant to study patient-navigation techniques. Eight are funded by the National Cancer Institute and 1 by the ACS. Patient navigation, first developed in 1990 by Harold Freeman, MD, at the Harlem Hospital Center in New York, New York, uses specifically assigned staff (patient navigators)to guide patients from the point of suspicious finding (ie, a test that shows they may have cancer) through treatment and beyond to help ensure timely diagnosis and treatment. These navigators help patients overcome barriers that exist in the complex cancer-care system, such as language problems, ethnic and cultural biases, transportation difficulties, and fear.

Part of GWCI's charge was to get 5 other hospitals and 3 community organizations to work together on the initiative. Their focus during the pastS years was on breast cancer patients, and at press time, they expected to release data in November 2010.

“We learned overthese 5 years that the barriers that affect access to treatment also affect access to screening and services after treatment is over,” Dr Patierno says. “As a result we created a longitudinal patient-navigation program that navigates across the full continuum of health-care, from screening to the survivorship period.”

The patient-navigation network is now a seamless program that enables patients to access care anywhere in the city, he adds.