Academy of Oncology Nurse Navigators Position Statement on Patient Navigation Research

The mission of the Academy of Oncology Nurse Navigators (AONN) is to advance the role of patient navigation in cancer care and survivorship planning by providing a network for collaboration and development of best practices for the improvement of patient access to care and quality of life.

The vision of AONN is to increase the role of and access to oncology nurse and patient navigators, so that all cancer patients may benefit from their guidance, insight and personal advocacy.

The goals include advocating for and validating the role of oncology nurse and patient navigators, supporting our members as they strive to improve patient care outcomes, and  increasing patient access to navigation and survivorship services during and following treatment.

One strategic way to achieve these goals is the application of research to support the role of patient navigation through surveys, analysis and research studies.

As the field of patient navigation matures, it is critical that ongoing rigorous evaluation and research is implemented in order to understand the best practices and short- and long-term impacts of patient navigation. All levels of research, from program evaluation to randomized trials, are needed to build this body of knowledge. Recent randomized trials conducted by the National Cancer Institute through the Patient Navigation Research Program at nine institutions across the country will provide important findings on the efficacy of patient navigation. However, more research and program evaluation will be essential to grow the body of evidence and provide results to drive best practices in the future.  As more accrediting bodies realize the benefit of navigation in overall care coordination for all patients it is predicted it will become standard of care.

As a leading professional organization in patient navigation, AONN can provide leadership and support to our members to facilitate program evaluation and research and disseminate these findings.   More specifically, our research goals are:

1. To increase knowledge related to various roles patient navigators provide to improve patient care and outcomes.
2. To identify areas of research that will provide evidence-based data to support both efficacy and long-term sustainability of the patient navigator role in patient-centered care and survivorship.
3. To engage and encourage potential research projects with the assistance of mentoring and possible collaborations with other organizations (e.g., Oncology Nursing Society [ONS]).
4. To provide opportunities in both mentoring in evaluation and research and dissemination of findings and best practices.

Short-term goals:

1. Establish a Research Committee to provide guidance to AONN in developing and implementing a research agenda.  This agenda would be broad-based and include program evaluation, quality improvement evaluation and peer-reviewed research. 
2. Survey members regarding any research they have already conducted regarding the role of navigation and determine if they would be interested in publishing it or joining on a workgroup to support the AONN research agenda.
3. Based on the survey results and Research Committee recommendations identify a research topic that will have a huge impact in the short-term and be somewhat easy to achieve. (example: embedding clinical trial discussion into the navigator documentation tool and capturing increased screening/accrual to a variety of clinical research opportunities). There is potential for this type of research to be conducted in multi-institutional urban, rural, academic, community settings.
   • Survey if any navigators have already done this type of study on a small scale as baseline
   • How many navigators document education, screening, or accrual to clinical trials
   • Investigate possible grant funding for this type of initiative with ONS as a collaborator.
4. Sustainability is another area that needs immediate attention because health care cost reductions are top of mind for all administrators regardless of the value the role brings to patient care.
   • Survey asking if anyone has done this type of downstream revenue support for the navigator role with some specifics, and whether they want to publish results
   • Survey members regarding how their role is financed and specific questions related to how they may be proving value to their institution both financially as well as in clinical outcomes for patients.
   • Survey oncology administrators regarding return-on-investment elements needed to support the role of navigation in their institutions
5. Promote publication of research results by navigators in the Journal of Oncology Navigation & Survivorship^® and other peer-reviewed medical journals.

Long-term goals:

1. Research regarding the various disciplines that provide navigation services and the impact each role has an overall care coordination
   • Hand off strategies---challenges and best practice models
2. Developing and facilitating research initiatives that are specific to each phase of care across the continuum of care, beginning with community outreach to promote awareness and early detection through survivorship care (short- and long-term)
3. Creating of navigation tools that promote effectiveness, efficiency and measurability for navigators to use while caring for their patient populations

Potential Areas for evaluation and research include:

• Sustainability
• Efficacy
• Navigator impact on timeliness of care
• Role in clinical trials
• When navigation begins and ends---Hand off challenges and strategies
• Transitioning from clinical navigation to survivorship navigation
• Creation of algorithms and guidelines to enhance patient navigation
• Evaluation of support services and gaps and how to meet these needs in an era of economic challenges
• Research on emotional well-being in families who are assigned navigators
• Identification of the best time in disease trajectory for navigation process to begin to make the most impact on patient outcomes---may be disease-specific