A Guide to Implementing Best Practices in Person ... - cancerview.ca

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Navigation: A Guide to Implementing Person-Centred Care September 2012ComponentsOrganizational CapacityBuildingPatient EngagementmMonitoring, Evaluation &ReportingDisseminationInputs • Staffing • IS/IT • Facilities • Materials/DocumentsActivitiesOutputsProcessOutcomesShort-TermOutcomesIntermediateOutcomesLong-TermOutcomes• Identify and promotechampions and otherpositive social influences• Develop policies andboundaries for navigation• Secure skilled human andfinancial resources• Develop intraorganizationalcommunicationmechanisms• Champions• Policy documents• Resource allocationdocuments• Improved infrastructureto support navigationprogram• Enhanced infrastructurethat supports an integratedapproach to navigation(PricewaterhouseCoopers LLP, 2010a)• Increased patient and family satisfaction withthe experience of care• Sustainability of navigation program• Create and implement processesto ensure that patientsand families that work withthe navigator:- Are informed about thenavigator’s function- Are aware of the scope ofthe navigator’s role- Participate meaningfully inthe navigation process andin evaluating the navigationprogram• Patient information sessionsand consultations• Patient navigation• Patients and families increasinglyinvolved in all aspects ofthe navigation process• Increased knowledge, awareness,involvement in, and understandingof the navigationprocess• Measurementdevelopment• Tracking and progressreporting of patients informedabout navigationfunction and availability,number of patients receivingnavigation, etc.• Barrier management• Sharing results• Data collection andreporting system• Progress reports• Continued implementationof QI and PDSA cycle• Increased understandingof navigation effectivenessand necessary modificationsat individual,team and organizationallevels• Increased patient and family awarenessof supportive care services andresources• Reduced patient and family stressand increased quality of life• Creation of mechanismsto share results and lessonslearned about thepractice of navigationwith internal stakeholders• Development of productsto share lessons learnedwith externalstakeholders• Participation in conferences,collaborations,etc.• Knowledge products• Collaborations• Conferences• Publications andpresentations• Internal and externalstakeholders increasinglyaware of existence ofnavigation programs• Increased understandingof navigation program byinternal and externalstakeholders, includingchallenges and opportunities• Increased patient and family knowledgeabout self-management and self-care• Reduced costs to cancer care system66
Navigation: A Guide to Implementing Person-Centred Care September 2012Appendix C:Guiding Principles for Knowledge Implementation(PricewaterhouseCoopers LLP, 2010b)Principle 1. Problem Assessment and Understanding: Early identification, supportedby evidence (e.g., patient and staff testimonials, needs assessments, local data), andthe subsequent introduction of knowledge can help alleviate a problem or issue.Principle 2. Tailoring to Local Context: Innovations need to be tailored to suit thelocal situation, organizational characteristics, patient needs, etc. The goal is to have aplanned and focused innovation that is suitable for the character and needs of the localcontext.Principle 3. Assessment of Individual Perceptions and Motivations: It is important toassess the individual perceptions and motivations of the intended users of the knowledge.The assessment should include an examination of individual values, beliefs incredibility of the knowledge, behaviours toward sustaining the knowledge, beliefsabout capabilities and confidence, emotional response to the knowledge, and the balancebetween competing options in order to make a decision about the behaviour.Principle 4. Barrier Identification and Management: Barriers to using knowledge mayinclude lack of understanding of the knowledge, poor attitudes toward using theknowledge, lack of skills for implementation and established habits. Those who wantto bring about change must assess the local situation for potential barriers that mayimpede or limit uptake of the knowledge. These barriers must then be managed bytargeting interventions to help minimize or remove them.Principle 5. Identification of Social Influences: Social influences such as teamwork,champions and norms can affect people’s behaviour when choosing whether or not toimplement knowledge. Positive role models, opinion leaders and social supports canhelp to facilitate knowledge uptake. Negative social influences can hinder knowledgeuptake and must therefore be recognized and addressed.Principle 6. Training and Coaching: Individuals need to understand new knowledgeand must learn when, where, how and with whom to use it. New skills will likely berequired. Training and coaching helps individuals take up knowledge by enhancingtheir understanding and by helping them develop the necessary skills for implementationwithin their practice environment. Training and coaching also serve to reinforceuptake by providing advice, encouragement, practice opportunities and feedback.Principle 7. Organizational Capacity Building and Infrastructure Development: Foran innovation to be implemented, the organization must be ready for change and beable to support implementation of the innovation. Innovations must fit with an organization’sstrategic aims and culture, must be well supported by an infrastructure that67
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