AONN+ Navigation Metrics That Support the Oncology Navigation Standards of Professional Practice.

OBJECTIVES: To offer a comprehensive overview of the critical elements contributing to the achievements of oncology navigation, address challenges in standardized implementation, and examine recent advancements influencing the acknowledgment and reimbursement of navigation services. Lastly, the AONN+ 35 evidence-based navigation metrics will be shared, emphasizing the five core metrics that should be utilized by all navigation models in all settings. METHODS: Employed in this review involves synthesizing information from established oncology organizations, documenting the development of navigator professional standards of practice and navigation metrics that measure patient experience, clinical outcomes, and return on investment, and analyzing outcomes from national studies and collaborations to present a summary of advancements in oncology navigation. RESULTS: The key components vital for ensuring the enduring success of programs encompass the core competencies of navigators, adherence to standards of navigation practice set by the Professional Oncology Navigation Taskforce, and the establishment of well-defined metrics specific to oncology navigation. CONCLUSIONS: Despite these advancements, challenges persist in implementing and recognizing the newly defined standards and metrics. Effective solutions involve aligning navigation programs with leadership, integrating standards into daily practice, defining navigator roles, measuring navigation program outcomes through defined metrics, and leveraging certifications. Standardized measurement and practice are imperative for national policy development and reimbursement models, aligning with the Cancer Moonshot's goal of high-quality, patient-centered, and cost-effective cancer care. IMPLICATIONS FOR NURSING PRACTICE: To contribute to standardizing measurement and practice in oncology navigation for national policy development and reimbursement models.

Solidifying roles, responsibilities, and the process of navigation across the continuum of cancer care: The Professional Oncology Navigation Task Force.

Since its founding in 1990, the profession of oncology navigation has grown and evolved. Although core concepts serve as a unifying thread throughout the profession, there has not been formal agreement on standardization of definitions, scopes, and roles for the various types of navigators. This has created challenges for sustainability, including reimbursement for navigation services. Emerging from the Biden Cancer Initiative's patient navigation working group, the Professional Oncology Navigation Task Force was created to serve as the voice of professional oncology organizations with an ultimate goal of solidifying definitions, scopes, and roles of navigators across the care continuum. Task group members are committed to cross-disciplinary partnership (including nursing, social work, and nonclinically licensed navigation). As the Task Force worked to define, refine, and disseminate professional standards (with input from the navigation community), the work done by the National Navigation Roundtable was vital to our evolving understanding of the profession. This article outlines the importance of that partnership and highlights the relevant findings of each article in this supplement of Cancer to the standardization work. LAY SUMMARY: Within the profession of oncology navigation, definitions, scopes, and roles of navigators have not been solidified. Standardization of the profession is critical to allow for continued growth and evolution as well as policy direction. This article introduces the work of the Professional Oncology Navigation Task Force, which created the Oncology Navigation Standards of Professional Practice with input from professional leaders and community stakeholders. The article also links the work of the National Navigation Roundtable and the critical need to coordinate and amplify efforts across groups.

Reshaping Nursing Workforce Development by Strengthening the Leadership Skills of Advanced Practice Nurses.

A nurse leadership program provides advanced practice nurses, many of whom have nursing professional development roles within their agencies, with a year of education, mentoring, and guidance to create and implement innovative models of care designed to improve population health. This article highlights program participants' leadership development outcomes, along with strategies to educate and mentor rising nurse leaders.

Palliative Nursing Summit: Nurses Leading Change and Transforming Care: The Nurse's Role in Communication and Advance Care Planning.

Advance care planning (ACP) is an essential component of quality palliative care that requires expert communication skills. Nurses are often the health care provider patients and families rely on when exploring their values and preferences and making treatment decisions. Therefore, communication and ACP was one of the 3 areas of practice addressed during the Palliative Nursing Summit. This article summarizes patient outcomes and nursing actions recommended by summit participants related to communication and ACP. Areas addressed included education, clinical care, research, and policy/regulation. Recommended patient outcomes included the honoring of patient/family preferences and the inclusion of ACP discussions during routine care and across the life span. Recommended nursing actions included the following: (1) nursing education (both undergraduates and practicing nurses) and competencies related to communication and ACP be developed and implemented; (2) primary palliative care, including communication and ACP, be included in the practice standards of all nursing specialties; (3) health care systems support conversations about ACP and related documentation; (4) research be conducted related to the implementation of patient/family preferences and related health care utilization; and (5) regulation and reimbursement be crafted to support nursing practice related to ACP and related conversations at the nurses' full level of expertise.

Partnerships of the Future.

OBJECTIVES: To explore how partnerships among private, nonprofit, and public organizations can be instrumental in addressing 21st century health care challenges. DATA SOURCES: Peer-reviewed studies and guidelines, journal articles, books, websites, and personal communication. CONCLUSION: Given the complexity of the health care environment and the need to transform the system, individuals and organizations will need to form partnerships that result in improved quality of care and decreased cost. Some recent initiatives have been successful and are included in this article. IMPLICATIONS FOR NURSING PRACTICE: In many communities and at the national level, there are agencies and organizations that are working independently, yet they have overlapping goals and the same intent. They compete for the same financial and human resources whether in academia, the care delivery sector, or non-profit associations. In the cancer care world, interprofessional teams are essential, yet much care is still delivered in silos. There are redundant patient advocacy organizations even for some of the less common cancers. Partnerships and collaboration will take new forms and require new skill sets in the future.

Identifying and addressing the needs of adolescents and young adults with cancer: summary of an Institute of Medicine workshop.

Cancer is the leading disease-related cause of death in adolescents and young adults (AYAs). This population faces many short- and long-term health and psychosocial consequences of cancer diagnosis and treatment, but many programs for cancer treatment, survivorship care, and psychosocial support do not focus on the specific needs of AYA cancer patients. Recognizing this health care disparity, the National Cancer Policy Forum of the Institute of Medicine convened a public workshop to examine the needs of AYA patients with cancer. Workshop participants identified many gaps and challenges in the care of AYA cancer patients and discussed potential strategies to address these needs. Suggestions included ways to improve access to care for AYAs, to deliver cancer care that better meets the medical and psychosocial needs of AYAs, to develop educational programs for providers who care for AYA cancer survivors, and to enhance the evidence base for AYAs with cancer by facilitating participation in research.

Time can make a difference.

Through developing education, research, practice, and advocacy resources, the Oncology Nursing Society has supported and developed us as oncology nurses and as leaders.

A seat at the table: redesigning cancer care.

The Institute of Medicine's ([IOM's], 2011) report, The Future of Nursing: Leading Change, Advancing Health, included the key message, "Nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States" (p. 221). That is a call for nurses to lead at every level-to have a seat at the table when critical decisions are being made. Those decisions extend from clinical care to national policy, and all require the voice of nurses. The annual Gallup (2013) Honesty/Ethics in Professions survey again listed nursing as the most ethical profession. With that trust and the IOM report, among other things, nursing is well positioned to be at many tables. Having a seat is not enough, though. Nurses must contribute to the action at the table.