CORDATA BLOG

Activities of a Spine Nurse Navigator

Posted by Michael Graham

February 22, 2013 at 5:33 PM

   

We ha­­­ve spent the past two months highlighting the value that nurse navigators bring to a spine center. Now that we have highlighted what to look for in a spine nurse navigator , appropriate navigator-to-patient ratios and the value of education within your spine program , it seems like an appropriate time to dissect the roles that effective navigators perform within comprehensive programs.

A review of the activities unique to the navigators utilizing Priority Consult Spine led us to break down their activities into four stages, beginning with the receipt of a referral and culminating with outcomes data collection at the end of treatment.  While no single nurse navigator is in a position to address every component individually, a comprehensive program might ideally develop its team to provide comprehensive services like the ones that follow.

Stage 1 – Managing new patient referrals

For most of our affiliated programs, navigation begins the moment a referral is received by the spine center.  At this stage, nurse navigators may educate new patients on the value of receiving care through the spine center.  Oftentimes, a personalized phone intake, focused on patient symptoms and previous treatments/diagnostic studies creates an opportunity to identify high risk patients and collect the necessary information for specialists to direct patients to the most appropriate specialist for their initial evaluation.

Stage 2 – Facilitating spine specialist recommendations and providing patient education

If a program is set up to provide an initial triage decision, the nurse navigator is often the best option to review the physician’s initial treatment or testing recommendations and educate the patient on the treatment options available. In cases where facilitation of imaging or therapy prior to the initial physician evaluation is required, a nurse navigator can direct the patients to facilities that are affiliated with the program, coordinate those referrals and even assist in obtaining insurance authorization.

Another critical element of the nurse navigator role is to apprise referring and primary care physicians of these initial treatment recommendations.  With the features available in the Priority Consult Spine application, nurse navigators can access letter templates and scripting to manage the process.

Stage 3 – Ongoing navigation and tracking of response to treatments

Standard navigation includes ongoing tracking of patients at predefined points in the patient’s care pathway.  Nurse navigators utilizing our Priority Consult Spine application have access to queues like the one below to organize their follow-up.

Ongoing Queue

By managing their ongoing queues, patients can be organized by their next follow-up dates, follow-up categories or simply alphabetically by last name.  The scope of ongoing follow-up is likely the most specialized element of navigation, with centers establishing criteria with their participating physicians. The level of follow-up a center chooses to provide is generally dictated by the number of patients being tracked and the navigation team’s capacity.

Most programs actively track, at a minimum, patient testing and those undergoing non-operative care. However, many programs do track patients all the way through surgery and follow-up.  Advanced programs may also monitor practice patterns and the effectiveness of treatment provided by individual physicians.

Regardless of scope, the primary objective of on-going navigation is to facilitate communication among patients, specialists and referring physicians.

Stage 4 – Outcomes data collection and protocol development

As clinical outcomes data management has become more important to the development of integrated spine centers, nurse navigators have begun to take a lead role in the management of these crucial programs.  Navigators are often responsible for enrolling patients in the program and following up with outcomes surveys at prescribed intervals.  The relationship that often develops between a nurse navigator and patient puts the navigator in a unique position to influence patient compliance.

In addition, navigators often take a role in developing outcomes reports to support accreditation, develop clinical algorithms with the participating physicians and offer a structure for clinician peer review.

Conclusion

Nurse navigators are an essential element of a comprehensive spine program, serving to:

*Enhance the patient’s overall experience


*Solidify referring physician relations


*Provide a clinical safeguard for patients and treating physicians


*Track patient progress and compliance


*Improve ancillary capture for the hospital


*Provide appropriate patient education


For more information on the value of nurse navigation, I hope you will take the time to register for our Nurse Navigation Panel on February 27 at 3PM EST.  During this one hour webinar, we will hear from three nurse navigators representing three distinct programs.  Please feel free to submit your questions in advance!

In the meantime, please take a few minutes to watch a few of our clients discuss their use of Priority Consult Spine to support their nurse navigation programs.

Topics: Michael Graham, Spine, Cordata Health, outcomes data, Navigation & Care Coordination

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