Monday, September 16, 2013

A Day of a Patient Navigator...and More

It is 9:00 am on a Monday morning and the Patient Navigator (PN) rushes to be part of the practice team daily huddle.  By 9:10 am the huddle is over and all important topics for the day have been addressed.  It is 9:15 am and the PN goes back to her office and logs in to the HBO/EHR to check for hospital readmission that took place during the weekend.  She looks for any of her assigned patients names.  It is about 10:00 am and the PN checks her afternoon appointments and makes one more reminder call to her patients. It is about 11: 00 am and an unscheduled patient Ms. Ramos comes to the PN office with a stack of papers.  Patient Navigator meets with Ms. Ramos and reviews the stack of papers and helps patient prioritize the documents that need to be addressed.  It is about 11:30 am and the PN asks Ms. Ramos if all possible to come back the next day to start working on the high priority forms and letters, patient agrees and schedules appointment.

It is about 12:00 pm and Patient Navigator spends some time reviewing her physician referral follow-up data base and checks the HBO/EHR for any referrals update.  PN updates her referral tracking excel sheet based on any results update.

It is about 12:30 pm and care navigator takes a 30 minute lunch break, then it is time to meet with the afternoon patient.  It is 1:00 pm and patient Ms. Smith comes in to meet the PN to talk about her housing issues and food stamp application.  PN sets the stage for the meeting by making the Ms. Ramos feel at ease and to help her focus on the most immediate needs she has.  As the PN is listening to Ms. Ramos housing and food stamps issues, the PN is also thinking about Ms. Ramos diabetes and how her A1c level is 12%, off the chart.  Then the PN gets a moment and asks Ms. Ramos about her last appointment with the PCP and what was the reason for missing the appointment.  Ms. Ramos tells the PN that her immediate concern is a roof over her head and food on the table, therefore, she does not have time to be going to any appointments with her doctor until she figures out where she will be next month and how she will feed her 4 young children.  PN regroups and tries to completed all the necessary paperwork for Ms. Ramos.  It is about 2:00 pm and PN says goodbye to Ms. Ramos and reminds her of coming back to her GYN appointment in 3 days, Ms. Ramos says "Yes, I will be there".  PN takes a minute to check her emails and sees ne from her supervisor asking for the most updated clinical referral roster and her patient roster, which were due in the morning.  PN check her referral excel sheet to make sure everything is in order before emailing it to her supervisor.  PN tries to enter her case notes in the EMR when the phone rings and there is a knock on the door, PN answers the phone and opens the door, on the phone is the reception announcing Ms. Smith asking for her, then at the door there is Dr. Raymond wanting to give PN a new patient referral.  The PN takes down Dr. Raymond information on the patients and runs to meet Ms. Gomez who is her 3:15 pm appointment.  The PN meets with Ms. Gomez and start her initial intake assessment which has about 8 different sections.  it is about 4:30 PM and the PN walks Ms. Gomez to the registrar office to schedule an appointment with the eye doctor for next week.  it is about 4:45pm and the PN tries to wrap up the documentation for Ms. Gomez.  It is 5:00 pm and the PN tries to check her next day morning appointments as part of her pre-planning.  Finally, the PN leaves the practice by 5:15 pm.

Can you add anything else that may be missing from a day of a Patient Navigator?  Fill in the gaps...!

About the Author:
Helen Dao, MHA
A Health Care Consultant
Dao Consulting Services, Inc.
"A Public Health Company Connecting Providers and Communities"
Email: helen@daoconsultingservices.com
Tel. (201) 448-2046
www.daoconsultingservices.com


Sunday, September 15, 2013

Health Literacy in Public Health

The face of North America has changed and continues to change.  Currently, there are almost 45 million people in the nation who speak a language other than English, and over 30 million who were born outside of the United States.  During the past decade, the number of Spanish and Asian language speakers grew by 50 percent.  Community clinics and health centers are in the position of improving quality of care through the understanding of cultural competence and the implementation of Limited English Proficiency (LEP) strategies in public health practice.  

Many Community Health Centers and Hospitals are integrating Patient Care Navigators as part of their Patient-Centered Medical Home Model and organization's strategic plan.  Training Patient Navigators (PNs) in Health Literacy is crucial because they can learn about the challenges and barriers that patients and families encounter when trying to access appropriate health care services.  It also helps them identify appropriate community resources and services for their patients/families based on their communication needs.

We want PNs to think of the patients/families not only from the health care and social services needs, but also from the communication needs perspective.  Sometimes health care providers and non-clinical staff may make the assumption that patients/families do not adhere to treatment and follow-up with appointments because they do not want or are just "Non-compliant", which word should no longer be part of a provider's vocabulary.  Many times patients/families display certain behaviors toward their treatment and health care needs not because they do not care, it may be that they do not understand the instructions or medication(s) given by their providers. Here is where I see the PNs coming in and playing a very important role in relations to Health Literacy, they can break down complex terms and medical information for their patients/families into simple terms and words, they also become advocates and mediators for the patients/families.

Below is the short version of a presentation I gave to a number of Federally Qualified Health Centers (FQHCs) recently.













About the Author:
Helen Dao, MHA
A Health Care Consultant
Dao Consulting Services, Inc.
"A Public Health Company Connecting Providers and Communities"
helen@daoconsultingservices.com
Tel. (201) 448-2046
www.daoconsultingservices.com