The Colorado Cancer Screening Program (CCSP), led by Andrea Dwyer, works with 25 safety-net health systems to provide free patient navigation services for cancer screening throughout the state. Even from the program’s onset, CCSP recognized the importance of building sustainability capacity for patient navigation services. Despite strong evidence for the effectiveness of patient navigation, CCSP saw a remaining need to further define the navigator’s role and value to other health care team members and stakeholders. To support patient navigation programs, CCSP wanted to better understand factors influencing sustainability and develop a standard approach for helping clinics address these common factors even as specific needs, strengths, and contexts vary.
CCSP inquired about the Program Sustainability Assessment Tool (PSAT) in May 2018 as the Clinical Sustainability Assessment Tool (CSAT) was being developed. However, neither tool alone quite met their needs. Because patient navigation programs often reside in clinical settings but rely on external community supports to reduce patient barriers, each tool addressed important factors for patient navigation. Working with the Center for Public Health Systems Science and stakeholders, CCSP adapted items and concepts from both the CSAT and PSAT to develop a new tool for patient navigation settings: the Patient Navigation Sustainability Assessment Tool (PNSAT).
Involving external stakeholders in the PNSAT’s development was crucial to ensure the tool could be used by a wide range of patient navigation programs and also provided an opportunity to promote the tool to key audiences. Having now put the PNSAT into practice, CCSP has found the tool complements their previously developed toolkit, Paying for Colorectal Cancer Screening Patient Navigation Toolkit Strategies for Payment and Sustainability, in helping health systems to assess and build patient navigation sustainability capacity. The PNSAT also informs health system’s program planning and quality improvement efforts, as well as CCSP’s training approach. While CCSP plans to continue using the PNSAT to assess and reassess partner health systems, they also hope the work can more broadly contribute to the patient navigation field’s understanding of sustainability.
The Colorado Cancer Screening Program (CCSP) is coordinated through the University of Colorado Cancer Center, with funding support from the Cancer Cardiovascular and Chronic Pulmonary Disease (CCPD) Grants Program. Andrea Dwyer is the Program Director and Elsa Weltzien is the Evaluation and Sustainability Coordinator.