Professional navigation framework: elaboration and validation in a Canadian context.

PURPOSE/OBJECTIVES To elaborate, refine, and validate the professional navigation framework in a Canadian context. RESEARCH APPROACH A two-step approach consisting of a qualitative evaluative design and formal consultations. SETTING Two applications of professional navigators in Quebec and Nova Scotia, Canada. PARTICIPANTS Patient navigators, medical oncology specialists, nurses and oncology staff, administrators, family physicians, patients with cancer, and patients' families and significant others. METHODS Individual interviews (n = 49) and focus groups (n = 10) were conducted with professional navigators, patients and family members, front-line staff, family physicians, and health administrators. Formal consultations (n = 13) occurred with clinical experts, managers, and researchers from across Canada. MAIN RESEARCH VARIABLES The interview guide was based on an evaluative conceptual framework integrating questions related to the implementation process of the role of professional navigators and their organizational and clinical functions. FINDINGS Results support a bi-dimensional framework and define key role functions. The first dimension, health system-oriented, refers to continuity of care. The second dimension, patient-centered, corresponds to empowerment. For each dimension, related concepts were illustrated from data. Examples of outcomes also were suggested. CONCLUSIONS The framework brings clarity to the role and functions of professional navigators and suggests relevant outcomes for program evaluations. INTERPRETATION With a clear definition of their role, professional navigators may be more efficient and less challenged in terms of setting priorities and making decisions while having to face demands from the health system and patients. The integrative framework could improve the effectiveness of cancer navigation programs.