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To develop an evidence-based reference model defining the exact boundaries of the missions and activities of the hospital-based cancer care coordination nurses, to clarify their roles and standardise practices for impact evaluation.

Design: A multiphase, mixed-methods modelling study was conducted. First, we collected qualitative and quantitative data on cancer coordination nursing practices through a multicentre cross-sectional study. Mixed data were mapped to a previously developed reference framework to derive the reference model. Setting: 10 French hospitals, varying in size and status, over 20 months (2018-2019). Participants: Thirty-six hospital-based cancer coordination nurses, 162 patients, 142 caregivers and 352 healthcare professionals from both hospital and primary care settings. Main outcome measures: Qualitative data on roles, activities and experiences were collected through observations, interviews and focus groups. Quantitative data on role perceptions and organisational context were gathered using standardised questionnaires assessing support, commitment, role conflict, patient quality of life, precariousness and caregiver burden.

We identified core missions such as active listening, clinical needs assessment and internal coordination, but also differences leading to a nurse typology into three groups: 'complex pathway coordinators', 'treatment specialists' and 'polyvalent nurses'. Only 'complex pathway coordinators', fully aligned with the reference framework, performed complete care coordination and correspond to the reference model.

The modelling provides a foundation for standardising cancer care coordination practices, improving training and establishing a standard intervention for evaluating cancer care navigation which the authors are still calling for.

NCT03350776.