Garrett County Regional Cancer Patient Navigator Program
Need: Comprehensive cancer services for residents of an 8-county, 3-state area in Appalachia.
Intervention: Using a Cancer Patient Navigation Tool Kit, a Maryland acute care facility led a multidisciplinary collaboration that provided the area's patients with expanded cancer treatment services.
Results: In addition to several new cancer-related programs, expanded services are now available for cancer patients, families, and cancer survivors.
Garrett Regional Medical Center (GRMC) is a 55-bed
acute care health facility in western Maryland's Garrett
County. Its service area
includes 8 counties within the Appalachian regions of
Maryland, Pennsylvania, and West Virginia, an area where
cancer is the second leading cause of death. Of
particular significance, the area's death rates from
colorectal and breast cancers are around 25% higher than
U.S. averages. Consortium leaders acknowledged these
statistics were likely related to the area's healthcare
access and transportation barriers — especially when
paired with the area's poverty levels and number of
underinsured, elderly, and disabled residents.
To address these problems, GRMC collaborated with Garrett
County's Health Department and Community Action
Committee, West Virginia University Medicine, and the
local American Cancer Society chapter in a comprehensive
effort to expand care for the area's cancer patients and
Key to the consortium's effort was implementing a
promising practice model from the Kansas Cancer
Partnership's Cancer Patient Navigation Tool Kit.
This tool kit — no longer publicly available as of
November 2021 — provided the operational framework for 2
nurse navigators to assist patients with aspects of
cancer care ranging from insurance coverage needs to
nutrition assistance to providing disease-specific
education and emotional support.
Due to transportation barriers, many patients in the area
were going without needed daily radiation treatment. To
bridge this access gap, GRMC staff and nurse navigators
advocated for a designated vehicle to make the 2-hour
round trip to the tertiary center's radiation treatment
The navigators also advocated for several additional
Palliative Care Program to assist patients in making
choices for their medical care when facing advanced
disease and a
Survivorship Program. The latter program offers a
wide variety of services to cancer survivors, including
promotion of healthy lifestyle choices and assistance
with post-treatment surveillance for cancer recurrence.
Because cancer preventive efforts are recognized as an
important part of any cancer program, nurse navigators
worked in partnership with the county's health department
to develop broader-reaching cancer screening programs.
During the 3-year grant cycle, 450 patients and their
families were provided with services.
Creation of several additional cancer-centric programs:
Palliative Care Program
Development of a transportation system allowing
patients access to radiation treatment
From January 2017
through April 2018, the van traveled 30,000 miles
Additional results included an increased number of
colorectal cancer screenings by offering testing other
GRMC is now translating the success of the
cancer-specific navigator program to 2 additional areas:
the Well Patient Program designed for patients with
multiple chronic conditions and a navigator program
linked to the emergency room.
Due to the program's success, the navigator program has
not only continued, but during 2019, drew the interest of
a local public health school.
West Virginia University School of Public Health now
has a Patient Navigation as an area of emphasis. The GRMC
program serves the school in the capacity of providing
expert presenters, clinical shadowing experiences, as
well as accepting interns.
Communities wanting to expand cancer care services
should note that nurse navigators can be central to the
For addressing patient needs associated with complex
chronic conditions or healthcare utilization, other nurse
navigator programs may provide the key personnel to
Kimi-Scott McGreevy, Assistant Vice President, Marketing & Development
Garrett Regional Medical Center
Hospice and palliative care
Networking and collaboration
National/Multi-State, Maryland, Pennsylvania, West Virginia
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programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural
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needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep
in mind that changes to the program design may impact results.