TOOLS

Here are tools for implementing a comprehensive patient navigation program at your community cancer center, including assessment tools, navigator job descriptions, and SOPs. Also included in this resource are sample intake and referral forms, tracking forms, discharge tools, and patient and physician satisfaction surveys.

1. Acknowledgments Page

2. Patient Navigation Levels I-III

3. Pre-Assessment Tool

4. Patient Navigator Responsibilities and Core Functions

5. Sample Patient Navigator Job Descriptions

• Care Coordinator
• Clinical Navigator
• Oncology Nurse Navigator
• Social Worker

6. Sample Patient Navigation Program Policies and SOPs

• Navigator Policy
• Navigation Program SOPs

7. Sample Patient Navigation Forms

• Cancer center patient assessment form
• Cancer center intake form
• Discharge planning assessment form
• Distress management tool
• Financial assessment form
• Patient navigation intake form
• Physician intake form
• Referrals to cancer care management
• Sample assessment intake form
• Sample tracking form
• Sample treatment summary and plan

8. Sample Patient Satisfaction Surveys

• Care navigation survey (Billings)
• Patient satisfaction survey (Fox Chase Virtua Health)
• Patient satisfaction survey (Multicare Regional Cancer Center)
• Physician satisfaction survey (Fox Chase Virtua Health)
• Sample A Patient satisfaction survey
• Sample B Patient satisfaction survey

9. Outcome Measures Tool

10. Bibliography/Resource List

No part of this ACCC Cancer Care Patient Navigation: A Call to Action training tools may be reproduced or transmitted in any form, or by any means, without written permission from the copyright holders and/or ACCC.