We recently surveyed Oncology Roundtable members about their program’s cancer support services, including detailed questions on their navigation program’s volumes, staffing, and operations. Read on to see how your patient navigation program stacks up against your peers’.
Over 90% of organizations employing navigators
Of our 144 respondents, 94% indicated that they employ navigators, including both non-clinical lay navigators and clinically-trained navigators. As shown in the pie chart below, 72% of programs have only clinical navigators, while an additional 20% employ both clinical and lay navigators. Only 1% of programs exclusively employ lay navigators.
Clinical navigators can have a variety of backgrounds, but by far the most common is a nursing background. 95% of respondents with clinical navigators employ a nurse navigator. Far fewer respondents have social work navigators (34%) or advanced practitioner navigators (17%).
Organizations employing a median of 3 clinical navigators
Reflecting the growing popularity of navigators, most cancer programs have more than one clinical navigator on staff. Of the 133 respondents that employ clinical navigators, the median number employed is 3.
When broken down by 2014 analytic case volume, as shown in the graph below, the number of clinical navigator FTEs employed by an organization increases in relation to the size of the cancer program. Programs with fewer than 627 analytic cases have a median of 1.5 clinical navigators, while programs with more than 2100 analytic cases employ a median of 7.
Majority of navigators organized by tumor site—breast navigators by far the most common
Over 70% of cancer programs have their navigators work with specific tumor site populations. Of the programs that organize their navigators by tumor site, 97% have a dedicated breast navigator. Programs reported dedicating more navigators to breast than any other tumor site with an average of 1.4 breast navigators per program. After breast, 82% of programs with tumor site-specific navigators have a dedicated lung navigator, followed by 57% with a colorectal navigator.
While it isn’t surprising that high-volume tumor sites are most likely to have dedicated navigators, tumor sites with complex patients also have dedicated navigators—over half of the respondents with tumor site-specific navigation employ head and neck cancer navigators.
Clinical navigators balancing a heavy workload
In our survey, we also asked respondents to indicate how many patients each clinical navigator manages. In 2014, clinical navigators managed an average of 316 patients and a median of 208 patients across the year. These numbers are significantly higher than data we collected in 2010, in which navigators managed a median of 150 patients.
Not only are navigators being asked to manage more patients, but they are also being asked to do more for each patient. We asked programs to indicate which tasks clinical navigators are performing. Over 75% of programs in 2014 indicated that each of their clinical navigators had 10 or more responsibilities. This is a dramatic increase from 2010, when 50% of programs said that their navigators regularly performed 8 or more responsibilities.