From service profit chain to service impact chain: an exploratory study of patient navigation programs and service impacts

Purpose – Patient navigation services assist underserved patients in overcoming barriers in healthcare systems. Expanding the Service Profit Chain (SPC) framework, this study aims to investigate how internal service quality contributes to achieving broader stakeholder outcomes, particularly reducing healthcare disparities and enhancing care coordination. Design/methodology/approach – This study adopts a qualitative multiple-case methodology involving ten healthcare organizations across diverse settings. Data were collected through semistructured, in-depth interviews with patient navigators, healthcare professionals and hospital administrators. Cross-case qualitative analysis was conducted to identify critical factors affecting patient navigation effectiveness and impact. Findings – Results show that patient navigation services help reduce healthcare disparities and enhance care coordination. As reported by navigators, patient navigation programs help to overcome barriers to care, improve patient engagement and support other stakeholders. Critical success factors include clear navigator roles, active physician involvement, sustained organizational support and secured funding streams. These elements significantly influence the navigation program effectiveness, more importantly, the broader social impact of patient navigation services as perceived by navigators. Practical implications – Healthcare managers and administrators may use identified success factors to optimize the design and implementation of patient navigation services, thereby increasing service efficiency, care quality and service social impact. Social implications – Successful patient navigation contributes to community health improvements, equity in care access and patient empowerment, reinforcing broader societal benefits beyond profitability. Originality/value – This study provides original empirical insights by integrating the Service Profit Chain with stakeholder theory in healthcare, offering a comprehensive Service Impact Chain (SIC) framework. By analyzing patient navigation services through the SIC perspective, this research highlights key success factors and the extensive social and stakeholder outcomes of patient navigation beyond traditional profitability measures.