title: From unit based to population focused: transforming the role of oncology clinical nurse specialists.
abstract: OBJECTIVE
  The aim of this study was to describe how the clinical nurse specialist (CNS) role can be positioned to proactively plan and facilitate evidenced-based best practices in collaboration with a transdisciplinary, population-focused team that manages the patient across the cancer care continuum. This model capitalizes on the spheres of CNS practice (patient, nurse, and organization) through the functional roles of the CNS (clinical expert, researcher, educator, and consultant) to maximize quality care.
  
  
  BACKGROUND
  The CNS practice in a Midwest comprehensive cancer center has been unit based, focused on nursing staff education, skills, and competencies. Practice varied based on the needs of the unit. With the aging population, rapid growth in research accrual, increasing referrals, and expansion of facilities and programs, a reexamination of CNS practice was undertaken.
  
  
  METHODS
  Nursing administration and CNSs evaluated the efficacy of transitioning to a population-focused model. Some responsibilities transitioned to other roles, the reporting structure was changed, and the role was realigned to a specific disease focus that encompassed care across the entire cancer continuum.
  
  
  RESULTS
  There was significant improvement in the areas of physician collaboration, autonomy, administrative support, teamwork, and contribution to the mission of the cancer program.
  
  
  CONCLUSIONS
  In this model, CNSs proactively plan and facilitate evidenced-based best practices in collaboration with a transdisciplinary team that manages the patient from diagnosis through the cancer trajectory, maximizing quality care and nursing-sensitive patient outcomes.
  
  
  CONCLUSIONS
  Healthcare organizations need to examine various roles for opportunities to focus on incorporating evidenced-based practices that will result in improved patient care and satisfaction.
authors.affiliation: James Cancer Hospital and Solove Research Institute, the Ohio State University-Comprehensive Cancer Center, Columbus, OH 43210, USA. kimberly.catania@osumc.edu
authors.forename: Kimberly
authors.initials: K
authors.lastname: Catania
authors.forename: Taletha
authors.initials: T
authors.lastname: Askew
authors.forename: Danette
authors.initials: D
authors.lastname: Birkhimer
authors.forename: Laurel
authors.initials: L
authors.lastname: Courtney
authors.forename: Deborah
authors.initials: D
authors.lastname: Hanes
authors.forename: Misty
authors.initials: M
authors.lastname: Lamprecht
authors.forename: Amy
authors.initials: A
authors.lastname: Rettig
authors.forename: Susanne
authors.initials: S
authors.lastname: Vendlinski
mesh_terms: D003266:Continuity of Patient Care; D003299:Cooperative Behavior; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D006801:Humans; D016294:Models, Nursing; D009720:Nurse Clinicians; D024802:Nurse's Role; D015401:Nursing Administration Research; D009859:Oncology Nursing; D010348:Patient Care Team