A Former Navigator’s Perspective

The needs for navigation services were as varied as the individuals in need. More often than
not, the person who recognizes the need is a family member, friend or neighbour and only
sometimes the person in need of services or a healthcare provider.

Many calls were requests to sort out what type of service to turn to in order to solve a particular issue or problem. Many only needed reassurance that they were on the right track and were doing all they could for a loved one. Some clients wanted assistance in finding and choosing a family physician. Others simply wanted up-to-date health information about their condition and what the options were in order to prepare for an appointment with their physicians. A lady called and wanted me to accompany her older sister during admission to hospital for open heart surgery. A lady called worried about an elderly neighbour who was seriously deteriorating and living in squalor. Some were desperate either with an acute sudden onset of symptoms or because of long outstanding pain and disability, getting worse while waiting for surgery.

Ten years ago when I first started to explore the idea of offering a personalized health
navigation service, an on-line search produced only two results related to health navigation: cancer care navigators in Nova Scotia and a private navigator in the U.S. focused on optimizing benefits of health insurance plans.

A Hospital CEO Perspective

Today the term “navigation”, although still not well defined, is commonly used in healthcare in Canada. There is even a merging profession of navigators with defined roles and responsibilities and certification. There is also talk of a “system of navigation” (NSM LHIN North Simcoe Health Integration Network in Ontario).

The needs that emerge from the navigator’s stories can be grouped under different themes:

• Access to services
• Advocacy
• Knowledge of available resources
• Knowledge of wellness, disease or condition
• Understanding the steps in the healthcare journey
• Accompaniment and interpretation of health lingo
• Comprehensive care plan and coordination
• Access to reputable health information

Why is navigation needed?

• The complexity of the system and lack of roadmaps
• The shift away from hospital based care to multiple community providers
• The importance of self-care and ownership of one’s own health
• The importance of the role of the family support system
• The need for culturally sensitive health services and information

Who provides navigation services?

• Self-navigation: use of internet, info-lines, informal networks
• Family members: parents, spouses, children
• Primary care providers: coordination of care and referral
• Every care provider: gives information and assists with transitioning into the next phase of the health care journey
• Health professionals within the system with official roles as case managers and navigators
• Personal navigators
• Societies or groups focused on specific conditions or diseases, peer navigators
• Police, firemen, pharmacists, emergency personnel all provide health services

information within their roles and sometimes referral to specific services.

The majority of people have only occasional need for health care services; when an accident
or illness strikes suddenly, all of us, even those of us who work in healthcare, find out how
little we actually know. There is no road map and every person’s journey is different and very personal. A person’s health record should be available on the computer to the patient and family caregivers who are part of the circle of care. This will greatly assist with managing one’s own care. Awareness of the need for health navigation will help accelerate the growth of a response to that need.