Effective implementation of patient navigation programs can be complex and daunting. Navigation is a foundational component in developing world-class cancer centers of excellence. Navigators ensure patients are compliant with their treatment plan by removing barriers, educating them, providing care coordination, and becoming a constant point of contact. For navigators to be successful, they need to be supported by a strong leader who can remove barriers to success, influence key program stakeholders about the importance of navigation, and demonstrate value of the program consistently.
Navigation leadership focuses on ensuring the top 3 navigation stakeholders—patients, physicians, and administrators—understand the value and key benefits of navigation. Navigators need assistance in developing models that ensure standardization, consistency, and collaboration within the program. They also need a place to escalate opportunities or gaps in the program to administrators who make financial and resourcing decisions. Navigation leaders must develop consistent navigation workflows and standardized navigator documentation to ensure navigation value is demonstrated. Each one of these stakeholders has a different “love language” when demonstrating value.
Our navigators most naturally communicate the value of navigation to patients. Many patients will describe their navigator as their “lifeline” and “angel” throughout their cancer journey. However, caring for patients effectively can be extremely inefficient if a navigation leader has not performed a gap analysis of the programmatic barriers before implementation of navigation. Implementation of resourcing to remove barriers to care, improve timeliness of care, and improve patient experience are critical to ensuring a successful program.
Physicians also need to understand the goals of navigation and have a point person to improve workflow issues and remove overarching barriers to clinical pathway adherence. Building trust and collaboration with physician groups is key to the success of a navigation program. In addition, these relationships must continue to be nourished as the navigation programs develop. Navigation is the great unknown to physicians until a leader can effectively and proactively speak to the efficiency gains and how the program will help improve patient outcomes.
Administration is also interested in all the value metrics of a physician. However, they understand “no money—no mission” and must be good stewards of the financial well-being of the hospital and cancer program. There are many innovative programs presented to our administrators every day that positively affect patient care. The goal of a great navigation leader is to demonstrate the quality, programmatic, and financial value of a navigation program. Navigation leaders ensure there are predetermined success metrics that are shared on a regular basis to demonstrate the value of a navigation program. A great method is to develop a monthly or quarterly navigation scorecard. Items such as growth, productivity, timeliness of care, pathway adherence, and patient experience would be key to demonstrate value to an administrator.
Data and Analytics
A strong scorecard leads to another key role of the leader of navigation. Many sources of data in a cancer program often go untapped. Cancer registry data are at the top of the list. Working with the cancer registrar to flag navigation patients can be a great way to demonstrate outcomes of a navigated versus a non-navigated patient. Navigation documentation, be it in an Excel sheet or a sophisticated navigation tool, is also critical to the success of demonstrating navigation value. Working with your administrators and physicians to identify navigation metrics early in program development sets up the program for success. Peter Drucker, business management leader, is quoted as saying, “If you can’t measure it, you can’t improve it.” As navigation programs mature in their data analytics, we will more efficiently add depth to our programs.
Navigation leaders are needed to grow and mentor the navigators. Navigators are usually identified for the position because they are strong employees who communicate well and are collaborative problem solvers. Navigators often become the “face of the program” and have many attributes of our future cancer program leaders. Mentorship and development of navigation employees is a critical part of the navigator leader role.
Many navigation programs have been unsuccessful because hired navigators are not provided training or leadership to ensure success. A navigation program has significant impact programmatically, clinically, and in ensuring physician/cancer team collaboration through the cancer patient journey. Navigation easily can become an invaluable investment in the cancer program when managed well. A navigation resource is far too precious and valuable to leave the success to chance. Navigation leaders should champion and advocate for the program, develop consistency and standardization, demonstrate value, influence positive change through data, and mentor and grow the next generation of cancer program leaders.