Development and Implementation of a Stroke Nurse Navigator Position to Improve Program and Patient Outcomes

Abstract

Background Transitions in stroke care across the healthcare system are complex, requiring significant patient and family support. Navigation has been used in other disease states including oncology but has not been described well in the stroke population. Methods Our stroke program leadership performed a gap analysis to identify opportunities to streamline the care transition process.  The emerging stroke nurse navigator role was implemented to meet patient/family needs and ensure implementation of evidence-based stroke services throughout transitions across the stroke system of care. Results The stroke navigator role was formally implemented in April 2018, along with adaptive patient selection criteria that have evolved as expertise in navigation has grown. Clarity in role function between the stroke coordinator and stroke navigator positions was established demonstrating the synergistic relationships between these two roles.  Similarly, interventions and services performed routinely by stroke navigators developed over time as navigators became well versed in the needs of patients and families in the post-acute phase of care. We provide a detailed history of our 6-year experience with stroke navigation and make recommendations for role adoption and enactment. Conclusion Stroke navigator roles are likely to continue to grow to support the complex needs of stroke survivors and family members.  Flexibility in role development and reflective role evolution are encouraged to support growth of the stroke navigator position and measures of role effectiveness.