Analysis of nurse navigators' activities for hospital discharge coordination: a mixed method study for the case of cancer patients.
Modern cancer care requires the development of clinical pathways to enhance coordination, but there are few descriptive studies about the content of coordination activities. More specifically, little is known about hospital discharge coordination, although this is seen as a sensitive phase of clinical pathway.



The purpose of this study was to identify and quantify the categories of activities performed by nurse navigators for hospital discharge coordination.



Patients supported within the Coordinating Outpatient Care department (COC) at Gustave Roussy (Villejuif, France). Study conducted over two consecutive phases (Feb-September 2014): (1) a qualitative phase to identify the categories of coordination activities (interviews with patients plus, focus groups with nurse navigators-NNs); (2) a quantitative phase to quantify the relative share of each category. The calls received through the telephone platform of COC (made by both patients and primary care providers) were systematically reported (caller; reason for the call; procedure performed) and then analyzed.



Qualitative phase: 17 interviews with patients, plus 2 focus groups with NNs. Quantitative phase: 543 calls analyzed. The callers were patients or their relatives (38 %), private nurses (35 %), medical device providers (20 %), and other primary care providers (e.g., pharmacists, family physicians) (7 %). Five categories of coordination activities identified: (F1) Patient monitoring (29 %); (F2) Helping to navigate (24 %); (F3) Managing technical problems (17 %); (F4) Explaining care protocols (16 %); (F5) Collecting and transmitting the patient medical record information (14 %).



The majority of requirements are related to organizational issues (e.g., navigation, lack of information, appointments). Nurse navigators' training and qualification must therefore combine both clinical and managerial skills.
Gustave Roussy, 114, rue Edouard-Vaillant, 94 805, Villejuif, France. fatimayatim15@gmail.com.|EHESP School Public Health, 15 avenue du Professeur Léon-Bernard, 35043, Rennes, France. fatimayatim15@gmail.com.
Fatima
0000-0002-5460-0197
F
Yatim
EHESP School Public Health, 15 avenue du Professeur Léon-Bernard, 35043, Rennes, France.
Paula
P
Cristofalo
Gustave Roussy, 114, rue Edouard-Vaillant, 94 805, Villejuif, France.
Marie
M
Ferrua
EHESP School Public Health, 15 avenue du Professeur Léon-Bernard, 35043, Rennes, France.
Anne
A
Girault
Gustave Roussy, 114, rue Edouard-Vaillant, 94 805, Villejuif, France.
Marilene
M
Lacaze
Gustave Roussy, 114, rue Edouard-Vaillant, 94 805, Villejuif, France.
Mario
M
Di Palma
Gustave Roussy, 114, rue Edouard-Vaillant, 94 805, Villejuif, France.|EHESP School Public Health, 15 avenue du Professeur Léon-Bernard, 35043, Rennes, France.
Etienne
E
Minvielle
D000368:Aged; D003266:Continuity of Patient Care; D005260:Female; D017144:Focus Groups; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000451:nursing* / Q000628:therapy; D024802:Nurse's Role; D009859:Oncology Nursing / Q000379:methods*; D010344:Patient Advocacy; D010351:Patient Discharge; D062526:Patient Navigation / Q000379:methods*; D013689:Telephone
Cancer patients; Discharge coordination; Nurse navigator