In July 2009, the Pacific Hospital PDA provided a two-year grant to Seattle Children’s to pilot the value of patient navigators for Somali- and Spanish-speaking families. Navigators assisted children and their families in using Seattle Children’s health care system and assisted providers and staff in their interactions with the families. The navigators were in constant contact with families, helping coordinate care, preparing families for meetings and appointments, and then accompanying them. While they fulfilled a different role than interpreters, they were sometimes called upon to provide interpretation in addition to navigation.
The Pacific Hospital PDA retained Clegg & Associates to work with Seattle Children’s to conduct a complete evaluation demonstrating the financial and patient-care impact of navigators. Clegg & Associates developed a tool that measured impact using the six Institute of Medicine Aims for Improving American Health Care (health care that is efficient, safe, timely, patient-centered, equitable and effective).
The two-year pilot grant with Seattle Children’s was completed in 2011, with significant positive results.
- In return for direct annual personnel costs of about $210,000, the program is estimated to have avoided about $1.2 million in inpatient costs.
- In addition, there were 62 fewer no shows, representing a $35,000 savings.
- The number of interpretations also increased with 18 additional discharge interpretations and 249 more daily interpretations during impatient stays.
- Excluding the favorable clinical and financial implications of the increased interpretations, the estimated return on direct investment is about 5.8. In other words, every dollar Seattle Children’s spent on patient navigators saved almost six dollars.
Patient & Provider Outcomes
- Patient and Provider Satisfaction: Patient families and providers were asked to provide feedback on a variety of topics. Statistically significant improvements in satisfaction between 2009 and 2010 were evident for both Somali- and Spanish-speaking patients and the providers who care for them. At the end of the two-year pilot, the majority of providers said that overall quality of care for these limited-English proficient patients was better or about the same as it was for English-speaking patients.
- Completed referrals and follow-up care: The Patient Navigators played a significant role in teaching families how to deliver correct home care and prevent emergency and hospital readmissions. They also helped families make and keep the appointments from physician referrals. At the end of the grant, families with patient navigators were more likely to complete referrals than families in the same language groups without patient navigators.
- Fewer missed appointments: The proportion of missed appointments decreased for families after their involvement in the navigator program (by 32% for Somali families and 21% for Spanish-speaking families). Both Somali- and Spanish-speaking families involved with the navigator program showed a lower proportion of missed appointments than others in their same language group who did not receive navigator services.
- One additional goal that emerged from the pilot was to “graduate” the families once they developed the ability to manage on their own without a patient navigator. In the last quarter reported, more than 20 percent of families receiving navigator services during the quarter graduated from the program—a remarkable success.
For more information on the project and the final report, contact firstname.lastname@example.org.
Seattle Children’s Hospital Foundation
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