Advanced Concepts in Navigation: Building the Navigation Business Plan

Nurses, especially those who have primarily worked in clinical and direct care settings, have historically had limited healthcare business acumen. Even the current nursing literature has little to help nurses improve their business savvy. Early nurse navigation programs were often supported through philanthropic fundraising efforts, and navigators themselves were often not directly involved in budgetary considerations. The most important “metric” of success was simply the number of patients served over a specified timeframe. Today’s navigation services are planned and developed as an integrated component of cancer programs. Nurse navigators are accountable for the business aspects of the program, identification of measurable metrics, data collection, and making their organizations’ return on investment readily apparent.

The adage “Failing to plan is planning to fail” is fitting here. Meticulous planning leaves nothing to chance, and avoids elements of surprise among colleagues, coworkers, and stakeholders. Even before planning processes begin, planners must fully understand their institution’s motivators for implementing a navigation program. A review of the literature identified 3 major institutional motivators for establishing navigation programs: The need to improve delivery of health and social services, the need to support and manage specific health needs, and the need to improve the quality of life and well-being of patients. Providers initiating patient navigation programs must identify motivators so benefits can be made easily visible to support implementation.

Creating a business plan is a fundamental and essential step in planning a new program or expanding an existing program. Information gathering contributes to planners’ articulation of elements of the business plan, including

• Detailed plans for the proposed program, project, or service
• Information to assess the venture’s financial feasibility
• Clearly stated objectives of the planned project
• Links objectives to accomplishment of the project or program goals
• Delineates method of running the activity over a specific future period

Typical elements of a business plan are:

• Executive Summary
• Introduction: mission, vision, goals (short and long term)
• Description of the business
• Market share and competition analysis
• Marketing or business strategies
• Development and implementation plan and schedule
• Organizational plan (staff requirements, qualifications profiles)
• Operational plan (operating expenses, initial and projected capital expenses, salaries, insurance, communication needs, building fees, office supplies, etc.)
• Financial plan: key revenue and expense metrics
• Appendix

Oncology nurse navigators have the potential to positively affect all aspects of cancer care. The success of a program depends on its leadership, planning and implementation processes, and the oncology nurse navigators employed in the program. Periodic assessment of program goals, shortcomings, areas for improvement, and potential changes are imperative to establish, maintain, and advance navigation programs that meet navigators’ career needs, expectations and aspirations, programmatic performance goals, and needs of patients, organizations, and communities.