Allies recently implemented a new organizational system to improve health outcomes and assist in care management for those receiving Allies residential services.
The Nurse Navigator program was implemented as part of a strategy to pursue more preventative care while reducing how much reactionary care is needed on a regular basis.
“What I wanted was for our nurses to see everyone and have a baseline for everyone we serve,” Dawn King, VP of Integrated Healthcare at Allies, said. The result of these efforts is a system where regional nurses took on the role of Nurse Navigator for an identified geographic area and get to know a set segment of those Allies serves.
Depending on their medical care needs, every person supported by Allies will be seen at a minimum frequency. People who have more complex medical challenges might be seen by their nurse once or twice each month, while folks who have less intense medical needs might be seen once or twice per year, King said.
In addition to getting to know the people they support; regular appointments are usually scheduled so that they coincide with the upcoming wellness doctor’s appointment. The early meeting allows nurse navigators and program managers to work together to create a strategy for the appointment. These planning sessions help to make sure everyone’s concerns are being investigated and properly evaluated, King said.
“You are able to help steer that doctor’s appointment and make sure you get the information you need,” Terrin Clark, LPN, a nurse navigator at Allies, said. “If you can prepare ahead of time, you know what to ask and what to expect.”
These strategy sessions are directly aligned with the program’s secondary goal of getting those supported by Allies to be more involved with their medical care.
Support from the nurse navigators does not end after their regular appointment, either. During doctor’s appointments, Allies staff often consult with the navigator. This team approach is centered around the shared goal of ensuring the best health outcomes for every individual.
According to Clark, these calls happen about five times each month. “It really works and is helpful because you can catch it in real time, and in many cases, we don’t need to set up a second appointment to get an answer or concern heard.”
The result of the program’s implementation has been an improvement of the level of preventative care throughout the agency.
“The program has been very successful in getting folks in for preventative care,” Clark said. “Just by going out and looking over the documents and medical consults, I can see if something is wrong.”
“Instead of people ending up in the emergency room, we are uncovering issues and are helping people to get treatment sooner than they otherwise would have,” King said.
The implementation of the nurse navigator program was a big project, and King initially predicted there would be some organizational growing pains, but the opposite was actually true.
“I was and continue to be very impressed with their engagement and also with the work everyone continues to put in to make the program successful,” King said.
“This just solidifies who we are as an agency,” King said.
Eventually, King hopes to harness data collected from the first year of the nurse navigator program to put best practices into place, furthering the goal of improving health outcomes for those Allies supports.