As our population gets older and the number of people living with chronic diseases rises, it will become more difficult to provide good quality care for people who live with advanced chronic disease and are approaching the end of life (EOL). Much research across Canada has shown that our healthcare systems often cannot meet the needs of these people in its current state. We need innovative ways to increase patient and family awareness of, access to, and coordination between services and supports that help people meet their needs and goals as they get closer to EOL. One potentially important approach is the delivery of community-based navigation programs that can educate patients and families, link them to critical health system and community services and supports, and support better coordination across healthcare settings.

This project will identify and compare how well community-based navigation programs, put in place across Canada, help individuals and families affected by advanced chronic diseases improve their access to services and supports, and achieve their EOL goals. We will also examine how these programs can best be implemented in other places. We will get this information through several different ways, including surveys and interviews with people who work in the programs (e.g., nurses, navigators, managers) and use the programs (e.g., patients, family members). The information we receive will be used to: understand how navigation programs work, for who, under what circumstances, and to produce what types of results; and to shape recommendations about whether and how to implement such programs in other parts of our country.