Assessing the Needs of Your Navigation Program Will Help to Achieve Goals

November 2011 Vol 2, No 6

“Patients come first” is the mission of the navigation program set forth by Tricia Strusowski, MS, RN, director of cancer care management at Helen F. Graham Cancer Center, Christiana Care Health System in Newark, Delaware.

A successful navigation program utilizes many tools to assess patient needs, resources, and treatment plans and to create navigator job responsibilities.

“We use a preassessment tool to list goals of the navigation program, including goals for administration, patients, families, navigators, and physicians,” Strusowski said. “We also need to know the barriers and the challenges to the program such as tumor types to be covered and the timeline for implementation.”

Preassessment also entails choosing a navigator and resources, including dietitians, social workers, financial counselors, and hospice services. Also of importance is a relationship with community patient support agencies.

“We partnered like crazy with the community,” Strusowski said. “We did not reinvent the wheel though. We had the wellness community, educational programs, and the American Cancer Society.”



George Washington Cancer Institute in Washington, DC, has developed the DC Citywide Patient Navigation Research Program to help patients who have problems with language, finances, and transportation.

“The citywide network crosses seven healthcare institutions and is made up of lay navigators, nurses, and social workers,” said Sharon Gentry, RN, MSN, AOCN, CBCN, a breast health navigator at Derrick L. Davis Forsyth Regional Cancer Center in Winston-Salem, North Carolina. “They’ve come to form a web across the city to help people get care, so it’s been incredible to watch this develop.”

Another program at the University of Medicine and Dentistry of New Jersey was led by a primary care physician who kept hearing horror stories of Latinos trying to navigate through the healthcare system for colon cancer screening, she said.

The navigators, who understood the culture and addressed the inherent community barriers, developed a resource guide with the patients’ input that could be used by navigators and care providers in the community. The focus became early cancer detection for this population, and the program, with the help of area churches and community organizations, bridged the gap between the community and the healthcare system.



Everyone’s job, first and foremost, is patient care, Strusowski said.

“You want to make sure that your job description really reflects what your navigator does. All the staff members in my department have very specific job descriptions. You have to be efficient and get the patients to the services they need as soon as possible,” she said.

“When patients arrive at the multidisciplinary center, we need to know the preliminary treatment plan. We also want to list their lead physician, so that physician takes ownership and does a comprehensive assessment.”

From the beginning of the program, Strusowski said she knew they would have to track and keep reports. Documenting patient and physician satisfaction is important, and the program’s basic tracking tool, with a patient identifier and date and time of appointment, has raised the level of care.

“My nurses are all cross-trained,” she said. “Nothing will fall through the cracks because we have order sets. I use my clerks to their fullest potential. Nurses need to do what nurses went to school for.”

And using the Midas computer system has helped with reporting to administration. “I can pull the very specific coordination of appointments that we’ve done. I send these tools to administration so they can see what we’re up to,” Strusowski said.

The final tool in Strusowski’s arsenal is a patient navigation satisfaction survey that is distributed in the private doctors’ offices.

“We keep it really simple, and it’s going to be a 1 to 5 scale. ‘Was your nurse navigator friendly? Did she answer your questions in a manner you could understand? Did she help you understand your course of treatment?’ From this, I’ll be able to give feedback to my nurse navigators and my support services because they deserve that,” Strusowski said.



According to the National Cancer Institute, a person is a survivor from the time of diagnosis until the end of life.

“But I think it’s critical that we need to hear that the survivor not only includes the patient. It includes family, friends, and caregivers. Everyone is affected,” Gentry said.

Questions for survivorship needs assessment within a navigation program include the following:

  • How do you define cancer survivorship in your community?
  • How do patients within your practice obtain survivorship services?
  • What type of survivorship services do your patients currently utilize?
  • Do you have enough local resources?

Survivorship care planning is also detrimental, Gentry said. Patients need help with some of the medical and physical effects of cancer treatment that may persist, including neuropathy, second primary tumors, infertility, and heart disease. Are the primary physicians in the community willing to take the patient back with some of these issues?

Psychosocial concerns also may persist. Depression, fear of recurrence, and physical problems are all on patients’ minds.

A navigation program can help survivors receive the care they need by:

  • Facilitating recommended surveillance for development of new cancers, and
  • Providing personalized support, such as educating survivors about their health needs and concerns and ensuring adherence to treatment and follow-up activities

Gentry said that patients can look to the American Society of Clinical Oncology and the National Comprehensive Cancer Network for answers to lingering questions.

Related Articles
2020 AONN+ Award Winners
January 2021 Vol 12, No 1
Each year, at the AONN+ annual conference, we pause to take note of the navigators and organizations among us who have made a significant impact in the field of oncology navigation. Although virtual, 2020 was no different, and it was with pride that we announced the 2020 class of AONN+ Award recipients. It is the distinct honor of the JONS Editorial Board and the AONN+ Leadership Council to recognize the navigators and organizations in our community who have made considerable contributions to our chosen specialty. This class of awardees includes a stellar group of navigators and organizations, each with their own unique and inspiring stories. Below, we tell their stories in the hope it provides inspiration to you in your professional life as an oncology nurse navigator or a patient navigator.
Preconference Workshops Allow for Additional Learning Opportunities
AONN+ 2020 Conference Highlights Special Feature
Attendees seeking to maximize the educational benefits of the conference took part in 4 preconference workshops, addressing topics including genetics and genomics, financial navigation amid the COVID-19 pandemic, professional development, and motivational interview skills for navigators.
AONN+ Awards Recognize Excellence in Navigation
AONN+ 2020 Conference Highlights Special Feature
Honoring the best in the navigation field, the AONN+ awards are presented each year in various professional categories, also recognizing a patient for outstanding contributions to the cancer community with the CONQUER: the patient voice Hero of Hope Award.
Last modified: November 15, 2022

Subscribe Today!

To sign up for our print publication or e-newsletter, please enter your contact information below.

I'd like to receive:

  • First Name *
    Last Name *
    Profession or Role
    Primary Specialty or Disease State