Models of care toolkit
About this section
This section describes how cancer care networks and network models of care can be used to enhance access to care.
Cancer care networks
Equitable distribution of care and efficiency of delivery is impacted by how cancer services are organized between and within cancer centres. Multidisciplinary clinics and cancer care networks are becoming more prevalent in Canada and internationally and help to improve the efficient use of health human resources and delivery of person-centred care.
Often focused on a single disease site, multidisciplinary cancer clinics are typically located at a single centre and bring together clinicians from multiple specialities, including allied health, with a focus on providing the full complement of care and services.
Multidisciplinary disease site clinics focus on person-centred care and enable all team members to work to their full scope of practice.
Identifying the best cancer network models
Patients benefit from the wide range of clinical expertise available at cancer centres; however a lack of care coordination can negatively affect patients.
The traditional model of care is structured around a single specialty (e.g., medical or radiation oncology, surgery, etc.) and can result in patients having to return for multiple visits and a duplication of consultations. This can lead to a general sense that “my care team doesn’t seem to be working together.” A lack of coordination disproportionately affects people impacted by the social determinants of health1 and patients without a primary care provider to help coordinate care.
Although cancer networks can take many forms, they are commonly organized for a specific disease site and connect two or more centres that share clinical expertise, resources, and services. Networks provide a structure for staff to work more closely across jurisdictions, institutions, and professional boundaries. They are often organized as centres of excellence or have expertise centralized at one centre with access shared across several centres in an area.
Organizing specialized care in this way helps support the flow of expertise and best practice and improves access and quality of care for patients, including those who require coordination of care across various settings.2 This type of approach can be particularly useful for patients living and receiving care outside of urban areas or across provincial and territorial boundaries.
Patient navigation as a critical component of cancer networks
Network models of care that include navigators help patients access care faster. A staff member is responsible for helping patients navigate through multiple appointments and for ensuring they receive the necessary care in a timely manner. Patient navigators promote a holistic, person-centred approach to care. Models that include patient navigators, improve patient satisfaction3 and they are crucial to care coordination for patients without a primary care provider.
- Andermann A. Taking action on the social determinants of health in clinical practice: a framework for health professionals. CMAJ. 2016;188(17-18):E474-E483.
- Riley-Behringer M, Davis MM, Werner JJ, Fagnan LJ, Stange KC. The evolving collaborative relationship between Practice-based Research Networks (PBRNs) and clinical and translational science awardees (CTSAs). J Clin Transl Sci. 2017;1(5):301-309.
- Stone CJL, Vaid HM, Selvam R, Ashworth A, Robinson A, Digby GC. Multidisciplinary clinics in lung cancer care: A systematic review. Clin Lung Cancer. 2018;19(4):323-330.e3.
- Brown BB, Patel C, McInnes E, Mays N, Young J, Haines M. The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies. BMC Health Serv Res. 2016;16(1).
- Hunter RM, Davie C, Rudd A, et al. Impact on clinical and cost outcomes of a centralized approach to acute stroke care in London: A comparative effectiveness before and after model. PLoS One. 2013;8(8):e70420.
- Reeders J, Ashoka Menon V, Mani A, George M. Clinical profiles and survival outcomes of patients with well-differentiated neuroendocrine tumors at a health network in new South Wales, Australia: Retrospective study. JMIR Cancer. 2019;5(2):e12849.
- Tremblay D, Touati N, Roberge D, et al. Understanding cancer networks better to implement them more effectively: a mixed methods multi-case study. Implement Sci. 2016;11(1):39.
- Labbe C, Martel S, Fournier B, Saint-Pierre C. P1.15-13 wait times for diagnosis and treatment of lung cancer across the province of Quebec, Canada. J Thorac Oncol. 2018;13(10):S615-S616.
- Sedgewick JR, Ali A, Badea A, Carr T, Groot G. Service providers’ perceptions of support needs for Indigenous cancer patients in Saskatchewan: a needs assessment. BMC Health Serv. Res. 2021;21(1)