HELENE HUDSON LECTURESHIP Developing a provincial cancer patient navigation program utilizing a quality improvement approach Part one: Designing and implementing

Jennifer Anderson, Sarah Champ, Kristina Vimy, Andrea Delure, Linda Watson


In 2012, the provincial cancer agency in Alberta initiated a provincial quality improvement project to develop, implement, and evaluate a provincial navigation program spanning 15 sites across over 600,000 square kilometres. This project was selected for two years of funding (April, 2012–March 31, 2014) by the Alberta Cancer Foundation (ACF) through an Enhanced Care Grant process. A series of articles has been created to capture the essence of this quality improvement project, the processes that were undertaken, the standards developed, the educational framework that guided the orientation of new navigator staff, and the outcomes that were measured. This first article in the series focuses on establishing the knowledge base that guided the development of this provincial navigation program and describing the methodology undertaken to implement the program across 15 rural and isolated urban cancer care delivery sites. The second article in this series will delve into the educational framework that was developed to guide the competency development and orientation process for the registered nurses who were hired into the newly developed cancer patient navigator roles. The third and final article will explore the outcomes that were achieved through this quality improvement project culminating with a discussion section highlighting key learnings, adaptations made, and next steps underway to broaden the scope and impact of the provincial navigation program. 

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Alberta Cancer Foundation (ACF) (2015). Annual Progress Report. Retrieved from http://albertacancer.ca/progress-report/spring-2015/patient-navigators

Alberta Health (AH) (2013). Changing our future: Alberta’s cancer plan to 2030. Retrieved from http://www.health.alberta.ca/documents/Cancer-Plan-Alberta-2013.pdf

Alberta Health Services (AHS) (2008). Evaluation Report: Provincial cancer patient navigation demonstration project. Internal document, AHS.

Alberta Health Services (AHS) (2013). Media release: Cancer patient navigators lend a helping hand. Retrieved from http://www.albertahealthservices.ca/news/releases/2013/Page8182.aspx

Alberta Health Services (AHS) (2015). Cancer Patient Navigation and Tumour Triage Resources. Retrieved from http://www.albertahealthservices.ca/info/service.aspx?id=1025354

Alberta Research Ethics Community Consensus Initiative (ARECCI) (2012). ARECCI guidelines for quality improvement and evaluation projects. Retrieved from http://www.aihealthsolutions.ca/initiatives-partnerships/arecci-a-project-ethics-community-consensus-initiative/

Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in nursing practice: Caring, clinical judgment and ethics. New York, NY: Springer.

Canadian Partnership Against Cancer (CPAC). (2012). Navigation: A guide to implementing best practices in person-centred care. Retrieved from http://www.cancerview.ca/idc/groups/public/documents/webcontent/guide_implement_nav.pdf

Cantril, C., & Haylock, P.J. (2013). Patient navigation in the oncology care setting. Seminars In Oncology Nursing, 29(2), 76–90. doi:10.1016/j.soncn.2013.02.003

Cook, S., Fillion, L., Fitch, M.I., Veillette, A.M., Matheson, T., Aubin, M., ... Rainville, F. (2013). Core areas of practice and associated competencies for nurses working as professional cancer navigators. Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie, 23(1), 44–52.

Dozois, E. (2010). Alberta Health Services (AHS). Cancer Patient Navigation Course. Internal AHS document.

Fillion, L., Cook, S., Veillette, A., Aubin, M., de Serres, M., Rainville, F., ... Doll, R. (2012). Professional navigation framework: Elaboration and validation in a Canadian context. Oncology Nursing Forum, 39(1), 58–69. doi:10.1188/12.ONF.E58-E69 A

Finance Alberta (2015). Alberta Population Projections by Census Divisions, 2015–2041. Retrieved from http://finance.alberta.ca/aboutalberta/population-projections/2015-2041-alberta-population-projections.pdf

Fitch, M. (2008). Supportive care framework. Canadian Oncology Nursing Journal/Revue canadienne de soins infirmiers en oncologie, 18(1), 6–14. doi:10.5737/1181912x181614

Freeman, H. (2013). The history, principles, and future of patient navigation: Commentary. Seminars in Oncology Nursing, 29(2), 72–75. doi:10.1016/j.soncn.2013.02.002

Freeman, H., Muth, B., & Kerner, J. (1995). Expanding access to cancer screening and clinical follow-up among the medically underserved. Cancer Practice, 3(1), 19–30.

Hébert, J., & Fillion, L. (2011). Gaining a better understanding of the support function of oncology nurse navigators from their own perspective and that of people living with cancer: Part 1. Canadian Oncology Nursing Journal, 21(1), 33–38. doi:10.5737/1181912x2113338

Langley, G., Moen, R., Nolan, K., Nolan, T., Norman, C., & Provost, L. (2009) The Improvement Guide: A Practical Approach to Enhancing Organisational Performance. San Francisco, CA: Jossey Bass.

Lorhan, S., Dennis, D., van der Westhuizen, M., Hodgson, S., Berrang, T., & Daudt, H. (2014). The experience of people with lung cancer with a volunteer-based lay navigation intervention at an outpatient cancer center. Patient Education & Counseling, 96(2), 237–248. doi:10.1016/j.pec.2014.05.002

McMullen, L. (2013). Oncology nurse navigators and the continuum of cancer care. Seminars In Oncology Nursing, 29(2), 105–117. doi:10.1016/j.soncn.2013.02.005

Miller, J. (2006). Cancer patient navigation needs assessment: Project report. Alberta Cancer board: Medical Affairs and Community Oncology Division, Internal Document.

Pedersen, A., & Hack, T. (2010). Pilots of oncology health care: A concept analysis of the patient navigator role. Oncology Nursing Forum, 37(1), 55–60. doi:10.1188/10.ONF.5560

Skrutkowski, M., Saucier, A., Ritchie, J.A., Tran, N., & Smith, K. (2011). Intervention patterns of pivot nurses in oncology. Canadian Oncology Nursing Journal, 21(4), 218–222. doi:10.5737/1181912x214218222

Swanson, J., & Koch, L. (2010). The role of the oncology nurse navigator in distress management of adult inpatients with cancer: A retrospective study. Oncology Nursing Forum, 37(1), 69–76. doi:10.1188/10.ONF.69-76

Thomas, M., & Peters, E. (2014). Setting-Specific Navigation. In K. Blaseg, P. Daughtery, & K. Gamblin (Eds.), Oncology nurse navigation: Delivering patient-centered care across the continuum. Pittsburgh, PA: Oncology Nursing Society.

Walsh, J., Young, J., Harrison, J., Butow, P., Solomon, M., Masya, L., & White, K. (2011). What is important in cancer care coordination? A qualitative investigation. European Journal of Cancer Care, 20(2), 220–227. doi:10.1111/j.1365-2354.2010.01187.x

Watson, L., Raffin, S., Melnick, A. & Whyte, D. (2012). Designing and implementing an ambulatory oncology nursing peer preceptorship program: Using grounded theory research to guide program development. Nursing Research and Practice. Article ID 451354. doi:10.1155/2012/451354.

Wells, K.J., Battaglia, T.A., Dudley, D.J., Garcia, R., Greene, A., Calhoun, E., … & Raich, P.C. (2008). Patient navigation: State of the art or is it science? Cancer, 113(8), 1999–2010. doi:10.1002/cncr.23815

Wilcox, B., & Bruce, S. (2010). Patient navigation: A “win-win” for all involved. Oncology Nursing Forum, 37(1), 21–25. doi:10.1188/10.ONF.21-25

World Medical Association (WMA) (2008). Declaration of Helsinki: Ethical principles for medical research involving human subjects. Retrieved from http://www.wma.net/en/30publications/10policies/b3/17c.pdf


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