Orlando Health

Zilipah Nichel

Zilipah Cruz is the Senior Director of Oncology Navigation, Survivorship and Community Outreach for the oncology service line at Orlando Health Cancer Institute, an integrated health system in central Florida comprising eleven hospitals and six cancer centers. In her role, she collaborates closely with physicians and leadership to develop, implement and sustain operations focused on care coordination, timely treatment, process improvement, education, prevention and screening programs for both patients and the community.

She holds a Master of Science in Nursing from East Tennessee State University and is an active mentor in BOLD: Mentorship Academy under the Academy of Oncology Nurses and Patient Navigators, where she guides navigators across the country. In addition to this, she serves as the President of Florida’s local navigation network, fostering connections among navigators across the state to facilitate networking, learning and the sharing of best practices within the industry.

From Bedside Nursing to Leadership in Oncology

My journey into oncology nursing was not entirely planned, but it quickly became my passion. I started as an inpatient oncology nurse, chosen to participate in a value stream analysis project that introduced me to Lean Six Sigma in healthcare. This exposure led me to a pivotal career shift, where I transitioned from bedside nursing to process improvement, overseeing 15 inpatient units and over 500 nurses.

Eventually, my path led me to outpatient oncology management, covering medical and radiation oncology and later, oncology navigation. Each role deepened my understanding of patient care, operational efficiencies and leadership responsibilities. It also reinforced my commitment to improving oncology services and ensuring patients receive the best possible care.

Addressing Challenges and Innovations in Oncology Care

Oncology navigation comes with its own set of challenges, particularly in defining the role. Every navigation program is unique, leading to ambiguity in responsibilities. To address this, we developed standardized workflows and ensured that new nurses and providers received structured onboarding, including shadowing opportunities. This proactive approach streamlines processes and improves communication within the healthcare system.

A major challenge in outreach is the financial burden of cancer care. Inflation and the increasing cost of living have made access to treatment even more difficult. Beyond education and screening, our team focuses on ensuring follow-up care for those with abnormal findings. We collaborate with grants and foundations to secure resources like transportation, lodging and financial support for patients, breaking down barriers to care.

One of our most significant innovations at Orlando Health is tracking and addressing barriers to care, which directly impacts patient outcomes. Research shows that patients with navigation support have reduced time from diagnosis to treatment. Our data-driven approach has helped improve patient adherence to treatment plans and reduce missed appointments due to logistical barriers.

Enhancing Patient Engagement and Survivorship Programs

To streamline care delivery, we implemented clinical pathways and created standardized checklists in our electronic medical records. This ensures consistency across all our cancer centers and allows us to track and improve performance. For patient engagement, we incorporated navigation-focused questions into our Press Ganey surveys, using the insights to enhance responsiveness and overall patient satisfaction.

Recognizing that survivorship is often overlooked, we established specialized survivorship clinics for breast, lung, head and neck and prostate cancers. These clinics, led by advanced practice providers, ensure that post-treatment patients receive continued care, follow-up screenings and lifestyle guidance to prevent recurrence. Standardization efforts continue to improve the robustness of our survivorship programs.

Goals and Advice for Aspiring Healthcare Professionals

Looking ahead, my goal is to develop clinical pathways for all major cancer types, further standardize survivorship programs and expand outreach efforts. A key aspiration is to launch a mobile low-dose CT unit for lung cancer screenings, similar to mobile mammography units. This initiative would bring essential screening services directly to communities, helping to identify and treat cases earlier.

For aspiring healthcare professionals, my advice is to embrace authenticity. It’s easy to fall into the trap of imposter syndrome, but true leadership comes from being yourself while learning from mentors. The qualities that make you unique will ultimately set you apart and add value to your role. Having a mentor is invaluable, but staying true to yourself while learning and evolving will set the foundation for long-term success.