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Navigation: A Guide to Implementing Person-Centred Care September 2012PricewaterhouseCoopers LLP. (2010b). Cancer Journey Portfolio Guiding Principles for KnowledgeImplementation. Prepared for the Cancer Journey Portfolio National Evaluation ofScreening for Distress, Navigation and Survivorship; Canadian Partnership Against Cancer.Rogers EM. (2003). Diffusion of Innovations. Fifth Edition. New York: Free Press.Rosenbaum M E, Ferguson KJ and Herwaldt LA. (2005). In their own words: presenting thepatient’s perspective using research-based theatre. Med Educ. 39(6):622-31.Rushmer R and Voigt D. (2008). Measure it, improve it: the Safer Patients Initiative and qualityimprovement in subcutaneous insulin therapy for hospital in-patients. Diabetic Medicine.25:960-7.Shapiro J and Hunt L. (2003). All the world’s a stage: the use of theatrical performance inmedical education. Med Educ. 37(10):922-7.Skrutkowski M, Saucier A, Ritchie J, Tran N and Smith K. (2011). Intervention patterns of pivotnurses in oncology. Can Oncol Nurs J. 21(4):218-27.Steinberg M. L, Fremont A, Khan D. C, Huang D, Knapp H, Karaman D, et al. (2006). Lay patientnavigator program implementation for equal access to cancer care and clinical trials:essential steps and initial challenges. Cancer. 107(11):2669-77.Stetler CB, Legro MW and Rycroft-Malone J. (2006). Role of “external facilitation” inimplementation of research findings: a qualitative evaluation of facilitation experiences inthe veterans health administration. Implementation Science. 1:23-30.Stevens B, Lee S, Law M, Yamada J and Canadian Neonatal Network EPIC Study Group. (2007).A qualitative examination of the barriers and facilitators to practice changes in Canadianneonatal intensive care units. Journal of Evaluation in Clinical Practice. 13(2):161-319.Stoll L and Fink D (eds). (1996). Changing Our Schools: Linking School Effectiveness and SchoolImprovement. Buckingham and Bristol: Open University Press.Swerissen H, Duckett SJ, Daly J, Bergen K, Marshall S, Borthwick C and Crisp B. (2001). Healthpromotion and evaluation: a programmatic approach. Health Promotion Journal ofAustralia. 11(1):1-28.Till JE. (2003). Evaluation of support groups for women with breast cancer: importance of thenavigator role. Health and Quality of Life Outcomes. 1(1):16-23.Virani T, Lemieux-Charles L, Davis DA and Berta W. (2009). Sustaining change: once evidencebasedpractices are transferred, what then? Healthcare Quarterly. 12(1):89-96.Walters H. (2011). Guidance note for the programmatic approach of the ICCO alliance.Accessed March 27, 2012. Available at: www.slideshare.net/compartuser/guidance-notefor-the-programmatic-approach-version-31122011White P and Hall EM. (2006). Mapping the literature of case management nursing. Journal ofthe Medical Library Association. 94(Suppl 2):E99–E106.58
Navigation: A Guide to Implementing Person-Centred Care September 2012Appendix A: Navigation Grid (Cancer Journey Action Group, 2010)General Definition of FunctionNavigation is a proactive, intentional process of collaborating with a person and his or her family to provide guidance as they negotiate the maze oftreatments, services and potential barriers throughout the cancer journey.Vision for Cancer Patient NavigationCancer Patient Navigation is part of an integrated system of cancer service delivery. Navigators work with the patient and family and their interdisciplinaryteam to assess needs, provide supportive care, answer questions, identify and address any barriers to quality care, and facilitate access to neededresources and services. Navigation aims to improve both coordination in services and continuity throughout cancer care, as well as quality of life for thepatient and family throughout the cancer journey.Overarching Goal of Navigation ProgramsNavigation programs aim to improve a person’s cancer journey by:• increasing capacity for knowledge and support• increasing capacity to meet identified needs• reducing anxiety• overcoming barriers and increasing capacity to access clinical and psychosocial services• improving coordination among individual services at various points and ensuring continuity across all servicesRole Descriptions Professional Navigator Peer/Lay NavigatorCharacteristics• is a health professional with specialized knowledge ofoncology• is part of an interprofessional team;provides an effective clinical function• performs formal, standardized clinical assessmentand intervention• provides person-centred care; ensures care team isaware of need for and meaning of a person-centredapproach• creates and follows a care plan at certain points orthroughout cancer journey in consultation with teamand person/family• is familiar with and collaborates with peer/laynavigators where applicable• engages in a pro-active, intentional process• coordinates care and services• actively monitors care at certain points or throughoutcancer journey• is a trained peer/lay person, sometimes paid• is often a person with a cancer experience• provides person-centred care• provides general information about cancerjourney• focuses on support, empowerment and selfcarefor patient• is familiar with and collaborates with professionalnavigators where applicable• engages in a proactive, intentional process• acts in response to concerns identified bypatient and family within scope of role• provides links or facilitates referrals tocommunity agencies and service providers• may facilitate referrals to health careprofessionals as needed and within scope of role• provides emotional support and/or sharespersonal experience within role guidelines59
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