Navigators work to keep patients from falling through cracks

Patient navigators - “like the air traffic controllers in health care” - captured the attention of Pamela Fayerman of the Vancouver Sun.

Fayerman explains that patient navigators are specially trained health care providers who help patients get access to care and services they need, serve as liaisons between patients and doctors and generally ensure patients don’t fall through the cracks of a complex health care system.

Fayerman’s five-day, multiplatform series on patient navigators was published last week and is a comprehensive look at this relatively new practice being applied to Canadian patients. She explores the roots of patient navigation in Harlem and goes on to document the evolution in Canada over the past decade.

In a story about one patient, Fayerman shows how the role of a navigator in getting efficient treatment, follow up and having a point of contact got the patient into the hospital for triple bypass surgery before she had a heart attack and sustained damage to her heart.

Other stories look at how navigators bring a culturally sensitive approach to treating members of the aboriginal community, as well as the unwillingness of Canadians to pay out of pocket for navigators, but:

In the U.S., where people are used to paying for health care, navigators are becoming more and more common - in both insured and non-insured settings and at for-profit and non-profit hospitals.

Fayerman, who used a $20,000 grant from the Canadian Institutes of Health Research, visited five provinces and 12 cities over eight months, interviewing nurse and other navigators, their patients and health system leaders. She explains why the series is important and how patients can be their own navigators.

Some Mass. hospital quality measures online

Mar. 9th, 2010 by Pia Christensen · Leave a Comment
Filed under: Health data, Hospitals 

Elizabeth Cooney, writing on White Coat Notes, alerts us to a change in data provided by the Massachusetts Hospital Association and the Massachusetts Organization of Nurse Executives.

PatientCareLink, the new site, adds examples of hospitals improving their performance and, for patients, gives advice on choosing a doctor or hospital, according to Cooney.

The site allows you to view hospital staffing plans and performance measures, such as prevalence of bedsores, patient falls, heart attack care, pneumonia care and surgical care.

Some of the data comes from Hospital Compare (also participating hospitals. And there’s no apparent way to download the data for analysis, as you can from the Hospital Compare site (and AHCJ).

Of course, ratings of Massachusett’s hospitals also are available from the Massachusetts Health Care Quality and Cost Council.

Joint Commission finds improved hospital quality

The latest report from The Joint Commission, a hospital accrediting organization, finds that “overall, hospitals are following evidence-based standards for treatment of myocardial infarction, heart failure, and pneumonia,” as MedPage Today reports.

The report, which looks at 31 evidence-based measures, did find decreases in two areas: measuring oxygen in blood for pneumonia patients and administering antibiotics to pneumonia patients in the intensive care unit within 24 hours.

The report, “Improving America’s Hospitals: The Joint Commission’s Annual Report on Quality and Safety 2009,” (PDF) and those from three previous years are available on the commission’s Web site. Among the key findings:

  1. Hospitals accredited by The Joint Commission have significantly improved the quality of care provided to heart attack, heart failure and pneumonia patients over a seven-year period.
  2. Hospitals have steadily improved on individual surgical care performance measures – as well as on additional individual heart attack and pneumonia care measures - over a two-, three- or four-year period.
  3. Hospital performance on two individual measures of quality relating to inpatient care for childhood asthma is excellent after only one year of measurement.
  4. Improvement is still needed.
  5. Where a patient receives care makes a difference.

As ProPublica’s Charles Ornstein explains in his tip sheet, The Joint Commission does routine inspections of participating hospitals to ensure they meet the standards required for accreditation. It compiles public reports on each hospital, which are available on the qualitycheck.org Web site. These reports include the hospital’s accreditation status, as well as some data on hospital outcomes and practices.

It does not release its detailed inspection reports to the public, and many states’ open records laws specifically exempt the reports from public disclosure. In the past, these inspections have not been surprises, and the group has been faulted for being slow to act against hospitals with problems Also, The Joint Commission rarely takes punitive steps against hospitals, preferring to work with them to improve.

Tip Sheets

A road map for covering your local hospital’s quality

Sorting out hospital rankings

Study: Hospital quality comparisons are inconsistent

News: Congress requires Joint Commission to re-apply for accreditation privileges (Sept. 17, 2008)