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
Dao Management Consulting Services, Inc.
Monday, September 16, 2013
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.
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
Sunday, July 28, 2013
Family-Centered Medical Home in Pediatric Care
I found a great article that speaks well and to the point about a framework of family-centered medical home in pediatric care.
For families that have a child with special health care needs, it is so critical for these families to have access to comprehensive care coordination as part of their medical home services. Care coordination helps families address four main components of the child and family's life; physical health, mental health, social health determinants, and the beliefs and practices of the family. The following article segments care coordination very graciously that we can appreciate how and who have the responsibilities for making care coordination successful.
http://mobile.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/May/Making%20Care%20Coordination%20a%20Critical%20Component/1277_Antonelli_making_care_coordination_critical_FINAL.pdf
About the Author:
Helen Dao, MHA
Dao Consulting Services, Inc.
"A Public Health Company Connecting Providers and Communities"
www.daoconsultingservices.com
Tel. (201) 448-2046
For families that have a child with special health care needs, it is so critical for these families to have access to comprehensive care coordination as part of their medical home services. Care coordination helps families address four main components of the child and family's life; physical health, mental health, social health determinants, and the beliefs and practices of the family. The following article segments care coordination very graciously that we can appreciate how and who have the responsibilities for making care coordination successful.
http://mobile.commonwealthfund.org/~/media/Files/Publications/Fund%20Report/2009/May/Making%20Care%20Coordination%20a%20Critical%20Component/1277_Antonelli_making_care_coordination_critical_FINAL.pdf
About the Author:
Helen Dao, MHA
Dao Consulting Services, Inc.
"A Public Health Company Connecting Providers and Communities"
www.daoconsultingservices.com
Tel. (201) 448-2046
Friday, June 28, 2013
"Social Determinants of Health"
Last month we discussed "Social Determinants of Health", here is a great article, "Public Health Reports / 2010 Supplement 4 / Volume 125". This article gives a brief history on how social determinants of health have being identified in the last 100 years. It also talks about the impact of quality of health and life, yet there are not specific outcome measures that will helps us collect solid data that will helps us demonstrate the impact. Social determinants of health such as education, risky behaviors, social economic level, cultural, and others can have an influence in how people manage their health, treat their condition, and acts proactively at staying healthy.
Here is the link to the article, great reading.
"Social Determinants of Health and Health-Care Solutions"
Helen Dao, MHA
Dao Management Consulting Services, Inc.
A Public Health Company Connecting Providers & Communities
Tuesday, May 28, 2013
Diabetes in Children and Youth
Diabetes in children and youth
There is no secret that we are in an era of alarming chronic health problems affecting people. More specific is the epidemic we see increasing among children and youth under 20 years of age.
Many studies consistently report the emergency for primary care providers to council parents and youth about healthy eating habits, increasing physical activity, and getting educated about diabetes. As et an article published by Hoffington Post, there are about 24 million people diagnosed with diabetes and 75 million as pre-diabetic. Another alarming statistic is that diabetes type 1 and type 2 is alarmingly increasing on the Hispanic community and little progress on education and prevention has been accomplished. But when it comes to the Hispanic community, how can we tackle this problem? It is important to go back to the beginning, mother's TLC (tender loving care) impacts the Hispanic children way of seeing and appreciating food.
Latin cousine is not just food for Hispanics, it is a way of a life style, it involves customs, traditions, flavors, portions, finishing everything served on the plate as a sign of satisfaction and politeness.
So how can we merge science and cultural practices? How can we better understand Hispanic's diet based on cultural costumes and traditions? These are critical questions and we better come up with some solutions to it. The future of out next health generation depends on that.
Our health practice (healthcare system) needs to change to a proactive approach.
We cannot continue being reactive to problems Health. Preventive and proactive steps need to happen in pediatric care. Children an family should receive ongoing healthy eating education as well learn about potential chronic diseases associated with obesity and diabetes. We need to create and sustain partnerships with parents and other primary care providers to build a culture around healthy living, good eating habits, and active Healthcare participation.
There is no secret that we are in an era of alarming chronic health problems affecting people. More specific is the epidemic we see increasing among children and youth under 20 years of age.
Many studies consistently report the emergency for primary care providers to council parents and youth about healthy eating habits, increasing physical activity, and getting educated about diabetes. As et an article published by Hoffington Post, there are about 24 million people diagnosed with diabetes and 75 million as pre-diabetic. Another alarming statistic is that diabetes type 1 and type 2 is alarmingly increasing on the Hispanic community and little progress on education and prevention has been accomplished. But when it comes to the Hispanic community, how can we tackle this problem? It is important to go back to the beginning, mother's TLC (tender loving care) impacts the Hispanic children way of seeing and appreciating food.
Latin cousine is not just food for Hispanics, it is a way of a life style, it involves customs, traditions, flavors, portions, finishing everything served on the plate as a sign of satisfaction and politeness.
So how can we merge science and cultural practices? How can we better understand Hispanic's diet based on cultural costumes and traditions? These are critical questions and we better come up with some solutions to it. The future of out next health generation depends on that.
Our health practice (healthcare system) needs to change to a proactive approach.
We cannot continue being reactive to problems Health. Preventive and proactive steps need to happen in pediatric care. Children an family should receive ongoing healthy eating education as well learn about potential chronic diseases associated with obesity and diabetes. We need to create and sustain partnerships with parents and other primary care providers to build a culture around healthy living, good eating habits, and active Healthcare participation.
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