Patient Navigators Help Reduce Emergency Department Visits

Employing patient navigators—nonclinical staff members who connect patients with essential care services—can significantly reduce the overuse of emergency departments (EDs) and the number of hospital readmissions.

A pilot program conducted at three hospitals in western Pennsylvania (USA), St. Vincent Health System (Erie, USA), Allegheny Valley (Pittsburgh, USA), and Jameson Health System (New Castle, USA) showed that using the navigators resulted in a 43% reduction in non-emergency use of the ED, a 60% reduction in 30-day readmissions for targeted diagnosis-related groups, and a 13% increase in colonoscopy screenings for early detection.

The navigators first had to pass an intensive three-day certificate program to give them a foundation for how to work with patients in the field. Then they received specialized training for their assigned patient population and designated location. Once they finished training, the navigators undertook patient follow-ups, connected patients to local care services, and scheduled physician appointments. The services rendered by the navigators helped offset clinicians’ tasks by about 25%, enabling them to focus more on the care of patients.

The pilot program was the result of a collaboration between the Patient Navigation Institute (PNI; New York, NY, USA), Accenture (Dublin, Ireland), and the Highmark Foundation (Pittsburgh, PA, USA) and deployed certified patient navigators to assist roughly 4,000 patients during the year of operation. Following the success of the pilot program, patient navigator training programs are scheduled to open in 35 locations across the United States.

“The essence of patient navigation is our responsibility to use finite clinical resources wisely to deliver quality healthcare no matter people’s circumstances,” said Harold Freeman, MD, founder of the PNI. “Its roots began in cancer care two decades ago, but the benefits of patient navigators are transferable, reaching beyond a single disease or income bracket.”

“Using patient navigators for nonclinical tasks also freed up physicians and other clinical workers to focus on tasks that specifically required their medical expertise; you could see a burden being relieved off their shoulders,” said David Balderson, MSc, who heads Accenture's patient navigation program. “Furthermore, from a patient perspective, the feedback has been phenomenal. They felt as though they found friends, people that were like them.”

“In initiating the pilot program, we recognized the opportunity to improve and assure timely access to quality healthcare for the communities we serve, while creating sustainable employment opportunities,” said Yvonne Cook, president of the Highmark Foundation. “We look forward to replicating the successes achieved in that study in other communities in the future.”

Related Links:
Patient Navigation Institute
Accenture
Highmark Foundation