Utilizing a Gap Analysis to Strengthen the Strategy of Navigation Programs

December 2019 Vol 10, No 12
Veronica Campos, DNP, MSN, RN, NE-BC, OCN
Division Director of Navigation – San Antonio
Sarah Cannon, The Cancer Institute of HCA Healthcare
Deidra Hamilton, MSN, RN, OCN, ONN-CG

Gap Analysis

A gap analysis is a tool utilized by organizational leaders to assess the current and future states of a program and to identify the differences or “gaps” between the programs. It is essential for a navigation leader to complete a programmatic gap analysis prior to the implementation of a navigation program. This important step will enable leaders to obtain the knowledge to implement the most appropriate action plan to bridge the gaps as well as provide a baseline with which to monitor the progress of the desired outcomes. A strong gap analysis provides a better understanding of opportunities and strengths of the program while also preparing for potential challenges. Leaders are encouraged to repeat their gap analysis at consistent intervals in preparation to respond to the unique and ever-changing needs of their stakeholders and healthcare systems.1


A healthcare system may be divided by divisions, markets, facilities, service lines, and tumor sites. Therefore, a gap analysis may be conducted at each level depending on the goals and needs of the organization. If leaders are seeking specific information on 1 tumor site of a navigation program, they are encouraged to conduct a gap analysis for only 1 facility and that specific tumor site. For example, if leaders want to assess the Breast Navigation Program for the market, they should conduct a gap analysis for a Breast Navigation Program at each facility in that market. It is important to conduct an individual gap analysis for each tumor site and facility because they may have different resources, which will create different gaps.

Gap Analysis Process

Five steps were identified to conduct a gap analysis of a navigation program (Figure). Each step of the process is utilized by the navigation leader to conduct a thorough assessment of the current navigation program, thereby leading to the development of an action plan to achieve the desired outcomes.1 All steps of the process may not be utilized, depending on the purpose of a gap analysis.

Figure Steps

Programmatic Gap Analysis

A programmatic gap analysis is simple and applicable to various programs. The analysis does not necessarily need to be a complex process. The gap analysis shown here consists of steps 1 to 3 of the process. This simple table includes all the necessary components for a desired navigation program. The current state of the program is evaluated and classified by the following: Gap identified; In progress—improvement opportunity; and No gaps—developed. It is important to be aware that a component may be classified as “No gaps—developed,” but it may not be in the best state. For example, a radiation oncologist consistently has 4-week wait times to first consult, and the component is classified as “Gap identified,” even though the radiation oncologist is unable to meet the needs of the patient population for the facility being assessed. Although the gap analysis only includes steps 1 to 3 of the process, it is still valuable information that can be shared with key stakeholders. The leader utilizes the table to provide a quick snapshot of the current navigation program and inform stakeholders of identified gaps (Table).

Table Example

Market Assessment

An assessment of the market can add value when combined with a gap analysis. The leader conducts a market assessment to gather in-depth knowledge when completing steps 3 and 4 of the gap analysis process. The following components are examples of components a leader can consider when completing a market assessment for a navigation program:

  • Current or future tumor sites to be assessed
  • Key stakeholders (leaders, surgeons, oncologists, radiologists, pathologists, nurses, etc) within each tumor site
  • Patient case volumes
  • Navigator full-time equivalent availability
  • Navigator productivity, workflow, metrics, and resources
  • Availability of facility or health system resources such as diagnostic procedures, minimally invasive surgeries, and robotic-assisted surgeries
  • Multidisciplinary conferences
  • Support services such as oncology-specific social workers, genetic counselors, financial counselors
  • Wellness programs, including dietitians, physical and occupational therapists, and survivorship care
  • Access to clinical research trials
  • Accreditations and certifications


A gap analysis identifies the differences between programs, allowing the leader to create an action plan to bridge the gaps and achieve the desired outcomes. By implementing and comparing routine gap analysis results, navigation leaders can easily assess the trajectory of the program. Through active assessment of market components, they can ensure programs are able to support quality patient care now and in the future.


  1. Davis-Ajami ML, Costa L, Kulik S. Gap analysis: synergies and opportunities for effective nursing leadership. Nurs Econ. 2014;32:17-25.
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Last modified: August 10, 2023

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