Impact of an innovative inpatient patient navigator program on length of stay and 30‐day readmission

Abstract

BACKGROUND The current climate of increasing patient complexity coupled with rising costs have prompted the need for adaptive innovation. There are limited data describing inpatient interventions targeting improvements in both communication and transitional care. OBJECTIVE Evaluate the patient navigator (PN) program, an innovative inpatient intervention intended to enhance navigation through the complexity of hospital admissions for patients and providers. INTERVENTION PNs were dedicated patient‐care facilitators without clinical responsibilities integrated as full members of the inpatient care team responsible for enhancing communication between and among patients and providers. DESIGN Observational retrospective cohort study. PATIENTS All patients admitted to the general medical service between July 2010 and March 2014. SETTING Academic medical center. MEASUREMENTS Primary outcomes were hospital length of stay (LOS) and 30‐day readmission rate matched by case mix group, age category, and resource intensity weight. RESULTS Our matched cohort included 5628 admissions (4592 patients) exposed and 2213 admissions (1920 patients) not exposed to PNs. Admissions with PNs were 1.3 days (21%) shorter than admission without PNs (6.2 vs 7.5 days, P < 0.001). Thirty‐day readmission rate was not different between the 2 groups (13.1 vs 13.8%, P = 0.48). CONCLUSION Implementation of this intervention was associated with a reduction in LOS without an increase in 30‐day readmission. Journal of Hospital Medicine 2015;10:799–803. © 2015 Society of Hospital Medicine

“We are doing it together”; The integral role of caregivers in a patients’ transition home from the medicine unit

“…As the population ages and patients have more chronic diseases, there are more services to coordinate at discharge, leaving less time for direct patient communication [ 34 , 35 ], a circumstance intensified by the push for shorter hospital stays [ 35 , 36 ], which is incentivized in the US and Canada through quality based funding [ 11 , 37 ]. Some hospitals are now involving transitional care specialists [ 38 ], and creating patient-friendly written instructions [ 13 ], but few are targeting barriers to engaging caregivers.…”

Improving quality outcomes in head and neck free flap surgery with the use of a physician inpatient coordinator

“…An inpatient patient navigator has been shown to decrease LOS and 30dUR for internal medicine patients . The navigator was neither a resident physician nor a physician extender and was without clinical duties; however, he/she served as a patient care facilitator.…”

“…An inpatient patient navigator has been shown to decrease LOS and 30dUR for internal medicine patients. 36 The navigator was neither a resident physician nor a physician extender and was without clinical duties; however, he/she served as a patient care facilitator. Dunn and Rogers evaluated a pediatric nurse practitioner to serve as a discharge facilitator where improved discharge times were achieved.…”

Hospital readmissions for COPD: a retrospective longitudinal study

“…35 Although studies of the effect of post-discharge care schemes suggest that COPD readmission risk may be modifiable, 34, 36, 37 these are tempered by contradictory findings from other initiatives that have been unsuccessful in reducing COPD readmissions. 38, 39 Despite efforts to reduce the number of admissions, total hospitalisations and emergency department visits for COPD have not decreased over the past decade. 40 Evidence of variation in readmission risk between hospitals may provide an opportunity for hospital managers and those commissioning services to improve the quality of care of COPD patients in hospitals with higher readmission risk.…”