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Negotiating Lay and Clinical Issues: Implementing a Lay Navigation Program in Cancer Care.

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Implementing lay navigation programs for cancer patients faces challenges. Effective integration with clinical teams is crucial for seamless patient care coordination and addressing complex needs.

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Area of Science:

  • Oncology
  • Healthcare Management
  • Implementation Science

Background:

  • Cancer patients experience significant care coordination challenges.
  • Lay navigation programs aim to mitigate these issues.
  • Successful implementation requires understanding and overcoming specific challenges.

Purpose of the Study:

  • To describe implementation challenges of lay navigation programs in an academic cancer center.
  • To inform future efforts in optimizing lay navigator programs.
  • To identify barriers and facilitators for effective program integration.

Main Methods:

  • Mixed methods study utilizing quantitative (electronic medical records) and qualitative (interviews, focus groups, observations) data.
  • Evaluation of standard implementation outcomes one year post-program initiation.
  • Study conducted at a National Cancer Institute-designated comprehensive cancer center across 12 tumor clinics.

Main Results:

  • Navigators frequently encountered supportive care, scheduling, and clinical issues.
  • Effective navigation involved continuous, resource-intensive work, including knowledge building and relationship cultivation.
  • Staff acceptance of lay navigator roles was mixed, highlighting challenges in defining clinical vs. non-clinical boundaries.

Conclusions:

  • Lay navigators struggled to interpret and prioritize patient needs acceptably for all clinical staff after one year.
  • Difficulties in negotiation hindered the development of strong clinical team relationships essential for integrated care.
  • Integrating lay navigation programs with clinical teams is recommended for improved patient care coordination.