An Emergency-Department Based Patient Navigator Program Bridging Gaps in Care for Vulnerable Patients

Our complex healthcare system can be challenging to navigate under the best of circumstances and these challenges are compounded for those who are uninsured, undocumented, living in poverty or have limited English proficiency. In 2009, our hospital initiated an emergency-department (ED)-based Patient Navigator Program to support, educate and empower patients to effectively navigate the healthcare system and receive appropriate and continuous care.  Located in 3 Northern Manhattan EDs, Patient Navigators, who represented the communities served, offered comprehensive education and support to underserved patients. They linked patients to health insurance/financial assistance, scheduled primary care and specialty appointments, and connected patients to community-based resources to address social needs.  In addition, Patient Navigators provided appointment reminders and follow-up calls to ensure that patients received the care that they need.

From December 2008 to September 2014, patient navigators supported 45,530 patients in the ED setting.  Seventy-seven percent of the 40,000 patients for whom an appointment was scheduled attended the scheduled appointment, and 90% of the nearly 25,000 patients without a primary care provider had an appointment with a new provider upon discharge.  Among high ED utilizers (6+ visits within 12 months) the number of ED visits dropped by nearly 50% post-navigation. These outcomes suggest that an ED-based patient navigator program is an effective approach to connect patients to the clinical and social services they need to better utilize health care system resources and, ultimately, to better manage their health.

In 2015, this program will expand to two additional EDs in Manhattan.