The following article features coverage from the 2018 Oncology Nurse Advisor Navigation Summit. Click here to read more news highlights and expert perspective from the Summit on Oncology Nurse Advisor. 

Oncology nurse navigators (ONNs) have a key role in the cancer care continuum. As patients transition to each stage along the cancer continuum — suspicious finding to diagnosis to treatment to survivorship — navigators help them understand their disease, weigh their treatment options, overcome barriers, and follow through with their care. “Navigation increased rates of treatment initiation among patients who typically failed to begin treatment within 90 days,” explained Judy B. Koutlas, RN, MS, OCN®, in a presentation at the 2018 Oncology Nurse Advisor (ONA) Navigation Summit.

Navigator programs are driven by a triennial community needs assessment established to address healthcare disparities and barriers to cancer care. As such, not all navigator programs are the same. Koutlas and Jean Sellers, RN, MSN, described the key development steps in building a navigation program.

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An important first step is the community needs assessment that identifies the patient population and collects data on system issues and gap analysis (current practices, cancer tumor registry volume, patient and community needs). This information helps identify the overall goals for a navigation program. Determine stakeholder perspective and concerns and seek out stakeholder engagement early. Get the whole range of care providers involved in the program. Navigation will be among and between all stakeholders, Koutlas and Sellers pointed out. 

Write a description of the role that also defines the responsibilities of the navigator. If this is a professional (eg, oncology nurse navigators, social workers, nurses) navigation program, consider the ideal educational background for potential candidates. Although lay navigator programs may be implemented by volunteers or nonclinical staff, Seller pointed out that they have to have training, support, and oversight by/engagement with clinical staff. An important component of the role and responsibilities is to identify the reporting relationship. Who is your navigator reporting to: a supervisor, a manager, or a nurse manager? 

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Marketing, internally as well as externally, is essential to getting a navigation program off to a good start. Before reaching out to the community, doctors and staff within the facility need to know the referral/consultation process and are educated on who should be referred to navigation services. Community outreach can be printed informational booklets for oncologists to give patients, as well as awareness activities and screening clinics. 

Use available orientation and training resources such as the Oncology Nursing Society (ONS) nurse navigator core competencies, developed in 2013 and recently updated, or the GW Cancer Institute core competencies for nonclinically licensed patient navigators, a free online program, was developed in 2014.