Remodelling of the Nurse Navigator role in the Emergency Department: Change corporate high heels and fancy gowns into clinical scrubs in one foul swoop

Mrs Nicole Altmann1, Mr Bryan  McKee-Hata1, Mr  Martin Ward1

1Royal North Shore Hospital, St Leonards, Australia

The Nurse Navigator role evolved in Australia in 2012 to assist the Emergency Department in achieving the National Emergency Access Target (NEAT) solely focusing on non-clinical aspects, such as supervision of nursing care, communication of outstanding nursing tasks and identification of eligible patient transfers in a high-paced unpredictable work environment. However, the Nurse Navigator role has not demonstrated an improved timely and safe patient management.

The innovative remodelling of the Nurse Navigator role into a purely clinical position in the Emergency Department of Royal North Shore Hospital, Sydney, in 2014 has shown improved collaboration between medical staff and nurses, a safer patient care and a better patient flow based on a survey and statistics.

This role modification decreases the patient’s length of stay by identifying barriers and focusing on clinical, rather than non-clinical interventions. This unique role re-design is able to identify hospital-wide barriers that impact on patient flow which are then addressed by working parties as part of the Whole of Hospital Program. It assists in a better understanding of interaction and influence of controllable and uncontrollable patient flow obstacles.

The recognition of patient flow barriers within the ED has led to the development of new models of care to respond to the findings. The Nurse Navigator role is still evolving.

Will other Emergency Departments follow this model in the future?


Martin Ward is a Clinical Nurse Consultant (CNC) in the Emergency Department (ED) at the Royal North Shore Hospital Sydney Australia.


Registered Nurse (UK)

Registered Psychiatric Nurse (UK)

Grad Dip Public Sector Management

Master of Management (UTS, Sydney)

He is an Associate Fellow of the University of Technology Sydney and a Fellow of the NSW College of Nursing