The Navigator’s Perception of Transitioning from a Single-Facility to an Integrated Multifacility Navigation Model

November 2018 Vol 9, NO 11
Beth Matthews, MSN, RN, OCN
Sarah Cannon
Susana Ulloa, MD, RN, OCN
Sarah Cannon North Florida Division, North Florida Regional Medical Center
Gainesville, FL

Background: There is extensive literature in change and transition management in leadership but limited literature from a non-managerial or navigator’s point of view. As the recipient of change, the quality of a transition has an impact on the navigator’s identity, job role, and model of care. A quality transition is vital for employee well-being, empowerment, productivity, satisfaction, and retention.1,2

Objectives: The purpose of this study was to capture the perceptions of navigators transitioning from a single-facility (SF) model to an integrated multifacility (IMF) model of navigation.

Methods: A single group pre- and posttest research design was used to examine the navigator’s view of job satisfaction, empowerment, access to resources, job-related training, and relationship with leadership. Navigators from 6 medical facilities within the North Florida Division participated in the study. A consecutive sample of 7 navigators completed a blinded, multiple-choice survey distributed online with a 100% response rate. Data were interpreted with a 5-point Likert scale that ranged from (a) strongly disagree; (b) disagree; (c) neutral; (d) agree; to (e) strongly agree. To compare the Likert data efficiently, individual responses were assigned a score of 1 to 5, and a mean score for each item was calculated. Pre-post differences were accessed using paired sample t tests.

Results: Posttest results demonstrated a positive relationship with the IMF model compared with the SF model. Navigators revealed improved understanding of the navigator’s role (P>.006), development of clinical pathways/metrics (P>.0009), skills effectively utilized

(P>.0001), voice in decision-making (P>.018), leadership had realistic expectations of navigators (P>.006), enriched feedback from leadership (P>.007), leadership listened to navigator opinions (P>.002), improved open communication with leadership (P>.005); enhanced access to clinical/clerical resources (P>.017), improved job-related training (P>.004), and satisfaction with career advancement opportunities (P>.005).

Conclusions: This study showed that the IMF model improved workplace satisfaction, employee empowerment, resource accessibility, professional development opportunities, and enriched leadership support according to navigators. Future longitudinal and comparative research is needed to explain the phenomena of navigator’s perceptions of various navigation models.


  1. Chick N, Meleis AI. Transitions: A Nursing Concern. 1986. University of Pennsylvania. Accessed March 22, 2018.
  2. Monarth H. Make your team feel powerful. Harvard Business Review. 2014. Accessed March 21, 2018.
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