| Course | BUSI 619 Quality Assessment and Evidence Based Decision Making (BUSI619) |
|---|---|
| Module/Week | 5 |
| Assignment | Literature Review Synthesis |
| Paper type | Literature review synthesis |
| Length | about 1,420 words, 5 double-spaced pages plus title page and references. Course guide: a synthesis of 1,400 to 1,700 words in current APA format on what the student has discovered about the chosen topic, with at least 8 references and biblical integration |
| Format | APA 7 student paper |
| Points | 100 |
| School | Liberty University Online |
| Program | MS in Healthcare Administration |
| Where it sits | Module/Week 5 in Liberty's published BUSI 619 course guide; current sections can differ |
| Updated | October 2026 |
Free sample paper for BUSI 619 Week 5
Literature Review Synthesis: What Twelve Studies Say About Patient Navigation, Who It Helps and What It Cannot Fix
[Student Name]
School of Business, Liberty University
BUSI 619: Quality Assessment and Evidence Based Decision Making
Literature Review Synthesis
[Instructor Name]
[Date]
The health system and its figures are composites; the textbook, Scripture and every research article cited are real.
Literature Review Synthesis: What Twelve Studies Say About Patient Navigation, Who It Helps and What It Cannot Fix
Introduction to the Synthesis
The question behind this synthesis is whether a navigator, set against ordinary follow-up, moves safety-net patients from a suspicious screening result to a firm diagnosis faster. Melnyk and Fineout-Overholt (2015) describe synthesis as the step in which a body of evidence is examined as a whole, so that the decision maker can see what the studies collectively support, how consistent they are and how strong the evidence is. Rather than review the twelve primary studies one at a time, this synthesis groups them into four themes: the size and timing of navigation's effect, the patients who benefit most, the barriers navigation does not remove and navigation's place within broader outreach programs.
How the Evidence Was Gathered
The twelve studies came from searches of PubMed and CINAHL using combinations of patient navigation, navigator, abnormal screening, diagnostic resolution, follow-up colonoscopy and time to diagnosis, limited to studies of adults published in English. I kept studies that reported original data on time to resolution or completion of diagnostic follow-up and excluded reviews, commentaries and studies of navigation during cancer treatment rather than diagnosis. Eleven studies come from the United States, and most come from the national Patient Navigation Research Program and its sites, which gives the evidence internal consistency but also means much of it reflects one era, 2007 to 2012, and one program model. Three recent trials and analyses from 2024 and 2025 extend the evidence into today's centralized, telephone-based programs. Melnyk and Fineout-Overholt (2015) place randomized trials near the top of the evidence hierarchy, and nine of the twelve studies are randomized trials or analyses of trial data, which makes this a relatively strong body of evidence for a health services question.
Theme 1: A Consistent Effect That Arrives Late
The randomized evidence agrees that navigation helps, and it agrees on something less obvious: the help comes late. The national Patient Navigation Research Program combined results for 10,521 people whose screening came back abnormal, nearly three quarters of them from minority groups and close to a third without insurance, and found no benefit during the first 90 days but a significant benefit from 91 to 365 days, with an adjusted hazard ratio of 1.51 for diagnostic resolution (Freund et al., 2014). Its metaregression found the greatest benefits at centers where usual care produced the longest delays. Individual trials show the same lag. In Ohio, where 18 clinics were randomized as groups, the trial found the effect of navigation became significant at six months, with a resolution rate 65% higher by 15 months (Paskett et al., 2012). In Tampa Bay, cluster randomized trials found no effect in the first three months for breast abnormalities, followed by a hazard ratio of 2.8 after three months (Lee et al., 2013), and only a marginal effect for colorectal abnormalities that did not become significant until 12 months (Lee et al., 2014).
The one individually randomized trial, at Denver Health, found that patients assigned a navigator reached resolution sooner for breast, colorectal and prostate abnormalities overall, though not for the highest-risk breast findings, which clinicians already pursue urgently (Raich et al., 2012). Read together, these studies suggest a mechanism: many patients complete follow-up promptly with or without help, and navigation's value lies in recovering the patients who would otherwise drift away. The evidence is strong in design, since it rests on randomized and controlled trials, but most trials randomized clinics rather than individuals, which can leave differences between sites. The lag also has a practical implication for administrators: a navigation program judged at 90 days could look like a failure even if it is working, so evaluation should cover at least a full year of patients.
Theme 2: The Patients Who Benefit Most
Secondary analyses of program data point to the patients for whom navigation matters most. Among 6,349 patients, those with a Charlson comorbidity score of 2 or more had significantly delayed resolution, and navigation reduced delays most for that group (Whitley et al., 2017). Older adults also benefited: in the Ohio trial, participants aged 65 and older who were assigned to navigation had a six-month resolution rate 127% higher than older adults in usual care, a benefit similar to that seen in younger participants (DeSalvo et al., 2018). These analyses are lower in the evidence hierarchy than the trials themselves, since subgroups were not randomized separately, but they are consistent with Theme 1: navigation helps most where barriers are highest. For a system with a limited number of navigators, that consistency supports prioritizing patients with multiple chronic conditions, older adults and patients with a history of missed appointments.
Theme 3: Barriers Navigation Does Not Remove
Navigation does not erase the social conditions that slow care. In the Ohio trial data, patients at federally qualified health centers resolved 39% more slowly than patients at academic medical centers before adjustment, but the difference disappeared once insurance, education and age were accounted for, and private insurance, college education, higher income and older age were each associated with faster resolution (Krok-Schoen et al., 2015). Among 801 women in the same program, time to resolution lengthened as neighborhood deprivation increased (Plascak et al., 2014). These findings mean that a navigation program will still see slower resolution among its poorest patients, and that pairing navigators with practical supports, such as transportation, interpreter services and financial counseling, is likely to matter as much as the navigator's phone calls. The Plascak study also found little sign that unmeasured factors were clustered geographically, which strengthens the conclusion that deprivation itself, rather than some hidden local factor, lengthens delays. For our system, the four clinics farthest from imaging and endoscopy serve the most deprived neighborhoods, so navigators there may need to arrange rides or bring services closer, such as scheduling diagnostic mammograms on the mobile unit.
Theme 4: Navigation Within Broader Outreach
Recent trials place navigation inside larger screening programs, often for colorectal cancer. In a pragmatic randomized trial at North Carolina health centers, mailed stool-test outreach with navigation to colonoscopy after a positive result raised screening completion to 30.0% from 9.7%, and 68.8% of intervention patients with positive results completed colonoscopy within six months, compared with 44.4% of controls, although with only 66 positive tests across both arms the gap could not be confirmed statistically (Reuland et al., 2024). Among rural Medicaid enrollees in Oregon, a combined program of mailed tests and navigation raised six-month screening completion to 11.8% from 4.5%, but navigation was actually offered to only 57.9% of eligible patients with abnormal results, showing how implementation can limit impact (Coronado et al., 2025). Evidence on reach suggests why: in a large health center program, 79.7% of patients assigned to navigation were reached within 18 call attempts, and 93.2% of those reached were contacted within six attempts (Gautom et al., 2024). Navigation's effect depends on navigators actually reaching patients, which takes persistence and staffing. The two recent trials also measured completion of colonoscopy rather than time to resolution, so their results are not directly comparable with the earlier trials, yet their results agree with the older trials and show that navigation remains useful when delivered by telephone from a central team rather than in person at each clinic.
Biblical Integration
When Jesus called Zacchaeus down from a tree and went to his house, he explained his mission in a single sentence: he came to seek and to save the lost (English Standard Version Bible, 2001/2016, Luke 19:10). Patient navigation is a modest, practical echo of that seeking. The evidence shows navigation helps most for exactly the patients the system is most likely to lose, which makes it less a convenience than a form of pursuit. A Christian administrator can see in that pattern a reason to fund navigation not as a marketing service but as a way of refusing to let vulnerable patients disappear after an abnormal result.
Summary
Taken together, the twelve studies support patient navigation as an effective way to shorten time to diagnostic resolution in safety-net populations, with effects that emerge after the first few months and are largest for patients facing the greatest barriers. The evidence is weaker on cost, on long-term outcomes such as stage at diagnosis and on how navigation performs in today's telephone-based and centralized programs. The final review will address what those gaps mean for our system's decision. For now, the synthesis supports three practical conclusions: navigation should be evaluated over a full year, it should be targeted first to patients with comorbidities, older age or a history of missed care and it should be combined with practical supports for transportation and language. A navigation program designed that way would rest on the strongest findings in the literature rather than on the general hope that more help produces better follow-up.
References
Coronado, G. D., Petrik, A. F., Leo, M. C., Coury, J., Durr, R., Badicke, B., Thompson, J. H., Edelmann, A. C., & Davis, M. M. (2025). Mailed outreach and patient navigation for colorectal cancer screening among rural Medicaid enrollees: A cluster randomized clinical trial. JAMA Network Open, 8(3), e250928. https://doi.org/10.1001/jamanetworkopen.2025.0928
DeSalvo, J. M., Young, G. S., Krok-Schoen, J. L., & Paskett, E. D. (2018). Characterizing time to diagnostic resolution after an abnormal cancer screening exam in older adult participants in the Ohio Patient Navigation Research Program. Journal of Aging and Health, 30(8), 1284-1304. https://doi.org/10.1177/0898264317715184
English Standard Version Bible. (2016). Crossway. (Original work published 2001)
Freund, K. M., Battaglia, T. A., Calhoun, E., Darnell, J. S., Dudley, D. J., Fiscella, K., Hare, M. L., LaVerda, N., Lee, J., Levine, P., Murray, D. M., Patierno, S. R., Raich, P. C., Roetzheim, R. G., Simon, M., Snyder, F. R., Warren-Mears, V., Whitley, E. M., Winters, P., . . . Paskett, E. D. (2014). Impact of patient navigation on timely cancer care: The Patient Navigation Research Program. Journal of the National Cancer Institute, 106(6), dju115. https://doi.org/10.1093/jnci/dju115
Gautom, P., Rosales, A. G., Petrik, A. F., Thompson, J. H., Slaughter, M. T., Mosso, L., Hussain, S. A., Jimenez, R., & Coronado, G. D. (2024). Evaluating the reach of a patient navigation program for follow-up colonoscopy in a large federally qualified health center. Cancer Prevention Research, 17(7), 325-333. https://doi.org/10.1158/1940-6207.CAPR-23-0498
Krok-Schoen, J. L., Kurta, M. L., Weier, R. C., Young, G. S., Carey, A. B., Tatum, C. M., & Paskett, E. D. (2015). Clinic type and patient characteristics affecting time to resolution after an abnormal cancer-screening exam. Cancer Epidemiology, Biomarkers & Prevention, 24(1), 162-168. https://doi.org/10.1158/1055-9965.EPI-14-0692
Lee, J. H., Fulp, W., Wells, K. J., Meade, C. D., Calcano, E., & Roetzheim, R. (2013). Patient navigation and time to diagnostic resolution: Results for a cluster randomized trial evaluating the efficacy of patient navigation among patients with breast cancer screening abnormalities, Tampa, FL. PLOS ONE, 8(9), e74542. https://doi.org/10.1371/journal.pone.0074542
Lee, J. H., Fulp, W., Wells, K. J., Meade, C. D., Calcano, E., & Roetzheim, R. (2014). Effect of patient navigation on time to diagnostic resolution among patients with colorectal cancer-related abnormalities. Journal of Cancer Education, 29(1), 144-150. https://doi.org/10.1007/s13187-013-0561-2
Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare: A guide to best practice (3rd ed.). Wolters Kluwer.
Paskett, E. D., Katz, M. L., Post, D. M., Pennell, M. L., Young, G. S., Seiber, E. E., Harrop, J. P., DeGraffinreid, C. R., Tatum, C. M., Dean, J. A., & Murray, D. M. (2012). The Ohio Patient Navigation Research Program: Does the American Cancer Society patient navigation model improve time to resolution in patients with abnormal screening tests? Cancer Epidemiology, Biomarkers & Prevention, 21(10), 1620-1628. https://doi.org/10.1158/1055-9965.EPI-12-0523
Plascak, J. J., Llanos, A. A., Pennell, M. L., Weier, R. C., & Paskett, E. D. (2014). Neighborhood factors associated with time to resolution following an abnormal breast or cervical cancer screening test. Cancer Epidemiology, Biomarkers & Prevention, 23(12), 2819-2828. https://doi.org/10.1158/1055-9965.EPI-14-0348
Raich, P. C., Whitley, E. M., Thorland, W., Valverde, P., & Fairclough, D. (2012). Patient navigation improves cancer diagnostic resolution: An individually randomized clinical trial in an underserved population. Cancer Epidemiology, Biomarkers & Prevention, 21(10), 1629-1638. https://doi.org/10.1158/1055-9965.EPI-12-0513
Reuland, D. S., O'Leary, M. C., Crockett, S. D., Farr, D. E., Ferrari, R. M., Malo, T. L., Moore, A. A., Randolph, C. M., Ratner, S., Stradtman, L. R., Stylianou, C., Su, K., Tan, X., Tang, V., Wheeler, S. B., & Brenner, A. T. (2024). Centralized colorectal cancer screening outreach in federally qualified health centers: A randomized clinical trial. JAMA Network Open, 7(11), e2446693. https://doi.org/10.1001/jamanetworkopen.2024.46693
Whitley, E. M., Raich, P. C., Dudley, D. J., Freund, K. M., Paskett, E. D., Patierno, S. R., Simon, M., Warren-Mears, V., & Snyder, F. R. (2017). Relation of comorbidities and patient navigation with the time to diagnostic resolution after abnormal cancer screening. Cancer, 123(2), 312-318. https://doi.org/10.1002/cncr.30316
What the BUSI 619 Week 5 instructions ask
The synthesis belongs to the fifth module/week of BUSI 619, when students also read the textbook's chapters 11 through 13, watch four short presentations, visit two assigned sites and post in Forum 6. The synthesis runs 1,400 to 1,700 words in current APA format and focuses on what the student has discovered about the chosen topic. It needs at least eight references and a biblical integration. Unlike the matrices, which describe studies one at a time, a synthesis compares and combines them, so the paper should be organized by themes or findings, with several studies discussed under each heading. This draft later becomes the core of the final literature review in Module/Week 7, so investing in clear themes now pays off.
How this BUSI 619 Week 5 example is built
The sample synthesis opens by restating the PICO question and explaining that twelve primary studies were grouped into four themes. The first theme examines the size and timing of navigation's effect, comparing the multisite pooled analysis with individual trials in Denver, Ohio and Tampa. The second examines subgroups, showing that navigation helped most for patients with multiple chronic conditions and for older adults. The third discusses barriers that remain, including insurance, education and neighborhood deprivation. The fourth considers navigation within mailed stool-test outreach programs, including a rural Medicaid trial and a health center trial, and evidence on how many calls it takes to reach patients. A biblical integration from Luke 19:10 follows, and the synthesis closes with what the evidence means for a safety-net system and where it remains thin.
BUSI 619 Week 5 grading rubric: where the points go
The synthesis in BUSI 619 is typically graded on whether studies are woven together under themes instead of being marched past one by one, whether claims are supported accurately by at least eight references, whether the biblical integration is thoughtful and connected to the topic and whether the writing stays within 1,400 to 1,700 words in APA format. Faculty reward syntheses that compare findings, explain differences between studies and assess the overall strength of evidence. Noting limitations, such as cluster designs or older data, shows critical appraisal. Ending on a frank verdict, naming how solid the findings are and where they run out, shows the student is ready for the final review. Transitions that connect themes help the paper read as one argument.
BUSI 619 Week 5 help: mistakes that cost points
Lay your two matrices side by side and group the studies by what they found, not by when they were published. Choose three or four themes and write a heading for each. Under each heading, compare at least two studies: the points of agreement, the disagreements and the likely reasons, such as design, setting or population. State the strength of evidence for each theme using the textbook's hierarchy. Place the biblical integration where it connects to the topic's meaning rather than as a closing paragraph. Close by stating plainly which conclusions the studies support and which questions are still open. Count words carefully, since the range is narrow, and check that all eight or more references appear in the text.
Related BUSI 619 sample papers
Other BUSI 619 weeks
- BUSI 619 Week 1: PICO Assignment
- BUSI 619 Week 2: Literature Matrix Part 1
- BUSI 619 Week 3: Literature Matrix Part 2
- BUSI 619 Week 4: Literature Review Introduction
- BUSI 619 Week 6: Discussion Board Forum 7
- BUSI 619 Week 7: Literature Review Final
- BUSI 619 Week 8: Literature Review Presentation
More MS in Healthcare Administration sample papers
- BUSI 511 Week 5: Discussion Board Forum 5
- BUSI 523 Week 5: Discussion Board Forum 2 Thread
- BUSI 528 Week 5: Vertical Integration Paper
- BUSI 611 Week 5: Discussion Board Forum 5
BUSI 619 Week 5 questions, answered
What is the BUSI 619 Literature Review Synthesis?
Worth 100 points in Module/Week 5, this 1,400 to 1,700 word paper integrates the student's research by theme, with at least eight references and a biblical integration.
Where can I find a free BUSI 619 Week 5 sample paper?
The complete BUSI 619 Week 5 sample on this page synthesizes twelve studies of patient navigation after abnormal cancer screening into four themes, with APA references.
What is the difference between a literature matrix and a synthesis?
A matrix summarizes each study in its own row, while a synthesis compares and combines studies under themes, explaining agreements, differences and the overall strength of evidence.
Why does patient navigation take months to show an effect?
In several trials, many patients resolved quickly with or without help, so navigation's benefit appeared later, among patients who would otherwise have drifted out of follow-up care.
What else is due in BUSI 619 Module/Week 5?
Forum 6 runs the same module/week, beside the textbook's chapters 11 to 13, four presentations and two assigned websites, so students usually draft the synthesis early.
Use it as a model, or ask for your own
This paper is an original model written by our desk for study. It is not a submitted student paper and not an official Liberty University document. Read it for structure and reasoning, then write your own to the instructions in your Canvas course. If you want a version built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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