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Navigation: A Guide to Implementing Person-Centred Care September 2012Brainstorm: Brainstorming is a way to develop creative solutions to problems. It canbe done informally in small groups or using a focus group. The session starts with anoutline of the problem and then participants are encouraged to come up with as manyideas as possible to solve it. One of the great things about brainstorming is that participantscan bounce ideas off each other and develop and refine them further.www.brainstorming.co.uk provides free online training in brainstorming, including therules of brainstorming and running a brainstorming session. (NICE, 2007)Run a Focus Group: Focus groups are a powerful means of evaluating current practiceand testing new ideas. They are a facilitated discussion with a group of six to 10 people.Open questions are posed by the facilitator, who then encourages the group to discusstheir experiences and thoughts, and reflect on the views of others. (NICE, 2007)Case Studies: Case studies are useful when very detailed information about a pastevent may shed light on existing barriers. (NCIS, 2006)Interviews: A face-to-face, one-on-one discussion with individuals who are asked specificquestions by an interviewer. Interviews can be unstructured, semi-structured orstructured. (NCIS, 2006)Surveys: A survey is a standardized set of questions to assess participants’ knowledge,attitudes and/or self-reported behaviour. The questions can be open ended, allowingparticipants to report their responses verbatim; closed, requiring participants to selectanswers from a predetermined list; or a combination of both. (NCIS, 2006)Nominal Group Technique: The Nominal Group Technique is a highly structured discussionamong a group of people whose ideas are pooled and prioritized. (NCIS, 2006)Delphi Technique: The Delphi Technique is an iterative process in which information iscollected from the same group of participants through a series of surveys. (NCIS, 2006)Arts-Based Techniques: Arts-based approaches to examining barriers offer the potentialto foster critical awareness, to facilitate understanding and to nurture sympathy.Dramatic performances have successfully helped health care professionals reflect on thecare they provide and increase their understanding of patient care issues (Kontos andPoland, 2009).32
Navigation: A Guide to Implementing Person-Centred Care September 2012The Process and PlanPromising practices collected from the jurisdictions implementing Navigation showthat a phased and systematic approach is required to effectively initiate a Navigationprogram (Consultation Nicolas Inc., 2012). Key elements of a phased approach to implementationinclude:• Selecting one clinic or disease site group that exhibits the greatest readiness tobegin implementation, followed by the next site that is most ready.• Creating an inclusive implementation team comprising staff representatives fromthe clinic or disease site. The team must have regular meetings about the processand plan for implementation and should have significant decision-making authority(within set parameters) about how the new practice will be integrated with thecurrent health care environment.• Working together to create a timeline and process map to implement Navigation.The plan needs to include assigned responsibilities for each task with regard to thesteps and activities for implementation, data collection, communication and reporting,and budgeting.• Reporting successes early and often to the sites, the administration and to communitypartners to keep the program “top of mind.”This chapter has provided a review of the key components to the planning and assessmentphase of implementing Navigation. The topic of implementation continues inChapter 5. By completing activities noted in this section, the management team has:• Established how Navigation can address local needs(problem assessment and understanding)• Assessed the organization’s capacity to lead andmanage practice change (self-assessment of changemanagement skills and the facilitator role)• Assessed barriers in the individual adopters and inthe practice environment (assessment of individualperceptions and motivations and barrier identificationand management)• Tailored the Program Logic Model to suit the localcontextPractice change thatrelies heavily on humaninteraction requires clearcommunication, a cleartheory of change thatmakes the case for thechange, and championswho consistently advocate,cajole, recognize,reward and encourage.E.M. Rogers, 2003• Created a phased approach to implementation, selecting clinics or disease sitesbased on readiness and enthusiasm to integrate Navigation33
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