Patient Navigators in Cochlear Implant Services: A Survey of Current Practices and Utilization

人工耳蜗植入服务中的患者导航员:当前实践和利用情况调查

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Abstract

OBJECTIVE: To understand current patient navigator (PN) use in cochlear implant (CI) programs and assess the perceived value of PNs in this context. DESIGN: A cross-sectional online survey was administered via Qualtrics-XM between February'24 and January'25. SETTING: Survey was distributed to CI professionals via the American Cochlear Implant Alliance's email list and social media. MAIN OUTCOME MEASURES: Demographics and PN use were summarized using descriptive statistics, and perceived PN value using a Likert scale from 1-not useful at all to 5-extremely useful. Barriers to care were categorized using an ecological framework. RESULTS: In total, 84 respondents completed the survey anonymously. Most were CI audiologists (n = 58, 69%), from urban (n = 57, 67.9%) and academic clinical settings (n = 41, 48.8%). Most reported not having someone fulfilling a PN role (n = 59, 70.2%). Only 9.5% (8) had a full-time PN, and 20.2% (17) had part-time PNs. Common PN duties included: navigating financial barriers, coordinating multi-specialty visits, addressing logistical issues (eg, transportation and childcare), and patient-tracking. Four PN responsibilities were rated "extremely useful": addressing emotional barriers, resolving logistical challenges, tracking patients, and coordinating multi-specialty visits. Totally, 251 open-ended responses spotlighted organizational barriers to care. CONCLUSIONS: PNs are uncommon in CI programs but are seen as highly valuable for addressing emotional, logistical, and systemic barriers. We offer a definition for the PN role to facilitate models of integration. As CI programs embrace both the existing disparities to care and the overall underutilization of CIs, integrating PNs into CI teams merits thoughtful consideration.

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