Best Practices for Patient Navigation: Six Rules of Physician Engagement
Developed by a joint Affinity Workgroup from Catholic Health Initiatives (CHI) and the National Oncology Service Line (NOSL)**, the Navigation Program Resource Guide provides evidence-based recommendations to create a consistent approach to navigation across their CHI’s oncology programs. And though the guide offers a full menu of tools, resources and templates specifically geared toward patient navigation, the authors’ insight into physician engagement can be applied to change management in any program that addresses patients’ essential needs.
“Physician understanding of and engagement with the navigation process is essential to successful program implementation.”
— CHI/NOSL Navigation Program Resource Guide
Physicians play a critical role in successful social needs initiatives, whether engaged only as program participants or as major champions of the work. This resource highlights the importance of physician involvement from the earliest stages of program conceptualization — offering six key rules and strategies to engage front-line healthcare providers throughout the process.
Rule #1: Involve key physicians up front in program planning and implementation.
According to Affinity Workgroup participants, it’s critical to engage early in the design process. One member drove this point home: “Physician involvement from the get-go ensures physicians feel engaged [and] valued. The guide (see appendix) offers examples of early opportunities to pull in physicians — including participation in Program Needs Assessments, helping to define the role of navigators in a new program, and even involvement in the navigator hiring process.
Rule #2: Identify and engage physician champions.
Few approaches can build support for a new social needs or patient navigation program more effectively than what guide authors call “peer-to-peer marketing”. But they rightfully point out that program administrators must identify and meaningfully engage physicians who are poised to be evangelists. In particular, these champions can be an incredible asset in program planning, assessment and improvement.
Rule #3: Promote navigator-physician collaboration.
There are a host of ways program staff can regularly touch base with physicians, from visits with office staff to participation in organization-wide steering committees. But guide authors recommend taking collaborations a level deeper — with physicians helping to identify program metrics and quality measures, develop joint referral scorecards, and participate in the creation of case studies.
Rule #4: Take advantage of opportunities to educate physicians.
Beyond relationship-building and office visits, there are a host of ways social needs program staff can raise awareness of the resources available to physicians and their patients. The guide authors share a number of recommendations, from scheduling presentations at regularly-scheduled staff or committee meetings, to placing informational fliers near physician dictation stations and EHR terminals. Perhaps the most intriguing idea: direct outreach to resistant physicians to learn more about their concerns with patient navigation programs and potential ways to resolve them.
Rule #5: Demonstrate program value.
Return-on-Investment (ROI) may seem like a bit of a buzz-term in the healthcare sector, but it is nonetheless important to consistently demonstrate social needs or navigation program value to participating physicians. Guide authors specifically state that it is important for physicians to not only be aware of outcome metrics that underscore program value, but they will ideally play an ongoing role in defining how quality and outcomes are measured. The guide also offers examples of potential measures, from general patient satisfaction to the impact of care coordination on specific outcomes.
Rule #6: Harness Physician Satisfaction Surveys.
Physician feedback is critical to identifying opportunities for improvement, remove barriers to patient referrals, or address other program challenges that might otherwise go unnoticed. Workgroup participants recommend a simple survey to not only draw in these insights, but also to give physicians a sense of involvement and identify potential education opportunities. A template survey is included on page 60 of the guide — along with distribution guidelines.