'Patient navigators' reduced readmissions, overuse of ER in pilot program

The use of "patient navigators" can significantly reduce the overuse of emergency departments and the number of hospital readmissions, according to a recent study

In a pilot program conducted by the Highmark Foundation and Accenture at three western Pennsylvania hospitals--St. Vincent Health System in Erie, Allegheny Valley in Pittsburgh and Jameson Health System in New Castle--nonclinical patient navigators helped patients gain access to essential healthcare services, according to the study.

Navigators first had to pass a three-day, intensive certificate program to "give them a foundation for how to work with patients in the field," David Balderson, who heads Accenture's patient navigation program, told FierceHealthcare in an exclusive interview. Then they received specialized training for their assigned patient population at their designated location, he added.

Once they finished training, navigators conducted patient follow-ups, connected patients to local care services and scheduled physician appointments. The system benefitted patients, physicians and healthcare leaders alike, Balderson said.

Hospital leaders "up and down the chain of command," especially C-suite executives, were pleased by how the use of patient navigators improved outcomes, and consequently, their bottom lines, he said.

These improved outcomes included a 43 percent reduction in non-emergency use of the emergency room, and a 60 percent reduction in 30-day readmissions for targeted diagnosis-related groups, according to the study. Overuse of the ED is a costly trend for hospitals and patients, and many hospitals are aggressively working to reduce their readmissions to avoid financial penalties, FierceHealthcare has reported.

Using patient navigators for non-clinical tasks also freed up physicians and other clinical workers to focus on tasks that specifically required their medical expertise, the study noted.

"You could see a burden being relieved off their shoulders," Balderson said.

Furthermore, "from a patient perspective, the feedback has been phenomenal," Balderson added. "They felt as though they found friends, people that were like them."

Following the pilot program at the Pennsylvania hospitals, the Harold P. Freeman Patient Navigation Institute, with the help of Highmark and Accenture, intends to roll out a patient navigator training program in 35 locations in the country, according to a statement about the program.

"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," Yvonne Cook, president of the Highmark Foundation, said in the statement. "We look forward to replicating the successes achieved in that study in other communities in the future."

But these organizations aren't the first to highlight or invest in the growing field of nonclinical healthcare workers. The positions of care coordinator and navigator both were featured in a 2014 report about emerging roles in healthcare, and another recent report indicated that demand is only expected to grow for such nonclinical and frontline jobs, according to FierceHealthcare.

"Providers are taking on more and more risk in terms of managing patients," Balderson said. "As we see that shift in risk from patients to providers, you're going to see more and more of these lay individuals come aboard to help manage that population."

To learn more:
- check out the study
- read the statement