Enhancing Cancer Patient Navigation: Lessons from an Evaluation of Navigation Services in Alberta, Canada.

Abstract

Cancer patient navigation has emerged as a patient-centric intervention enabling equitable cancer care, by mitigating barriers patients encounter throughout their cancer journey. Cancer Care Alberta (CCA) implemented a professional navigation model over a decade ago and commissioned a program evaluation in response to evolving operational demands. The objectives were (1) to better understand the current state of CCA's cancer patient navigation program; (2) to explore the need for other specialized streams; and (3) to provide key recommendations to strengthen and grow the program. A mixed methods approach, including a survey, administrative data, and semi-structured interviews, captured patient-, staff-, and system-level insights. Findings revealed difficulties in identifying complex patients needing navigation, along with inconsistencies regarding intake practices, program awareness, referral pathways, standardized workflows, and a lack of programmatic supports, which contributed to variability in service delivery. A need for enhanced palliative navigation support also emerged. Approximately 25% of surveyed patients reported being unable to access perceived needed support before their first oncology consultation. These findings underscore the importance of early, targeted navigation for equity-deserving populations. Recommendations include harmonizing program structure, refining navigator roles, expanding navigation streams, standardizing processes, and enhancing equity-focused competencies. These findings offer a roadmap with which to improve person-centered cancer care.