Hospital-based patient navigation programs for patients who experience injury-related trauma and their caregivers: a scoping review

Abstract

ObjectiveThis review’s objective is to map the literature on the characteristics, impact, barriers and facilitators of hospital-based patient navigation programmes that support patients who experience injury-related trauma and their caregivers. Patients who experience injury-related trauma frequently require support from multiple care teams and face many challenges to care, both in hospital and when transitioning across settings and services. Patient navigation can improve their care.DesignThis review is conducted according to JBI methodology for scoping reviews. The initial database search took place on 6 June 2021 and the grey literature search took place between September and October 2021. The results are presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses for Scoping Reviews flow diagram.SettingThis review considered materials where the patient navigation programmes were delivered in hospital settings. There was no geographical limit to this study.ParticipantsThis review focused on hospital-based patient navigation programmes for patients who experience injury-related trauma and/or their caregivers.ResultsThis review captured 11 records that describe 10 programmes. All programmes were based in the USA. Most programmes provided education, care coordination, discharge planning, and referrals to resources, services, and programmes to assist patients and/or their families in the hospital or the community. Half the programmes were based in level 1 trauma centres. Common impacts included decreases in readmission rates and increases in satisfaction rates. Barriers included difficulty recruiting or enrolling patients with short hospital stays and hospital administrators’ and healthcare providers’ lack of understanding of the navigator role. Navigator background, either professional or experiential, was identified as a facilitator, as was flexibility in programme delivery and communication methods.ConclusionsEleven records show a small but distinct sample. Reported characteristics, impact, barriers and facilitators were consistent with findings from other patient navigation studies. The results can inform the development and implementation of similar programmes in trauma centres and support changes in policy to improve the delivery of care.

Effects of prior injury on long term patient reported outcomes after trauma

“…Previously injured patients may even be able to play a direct role as a navigator, although data evaluating the performance of navigators with this background is limited. 27 While this study did show improved or equivalent HRQoL outcomes for patients with PTI compared with those without PTI, this is still within the context of substantial decline from the pre-injury baseline that has been previously reported. 5 Furthermore, the patients suffering recurrent injury also had a trend toward a higher rate of PTSD.…”

“…Patient navigator services may be one such tool to enhance recovery and have been shown to improve trauma patient satisfaction and decrease readmissions. Previously injured patients may even be able to play a direct role as a navigator, although data evaluating the performance of navigators with this background is limited 27 …”

Patient Adherence Following Knee Surgery: Evidence-Based Practices to Equip Patients for Success

“…Navigation programs are suggested as a good opportunity to overcome this barrier, leading to reductions in readmission rates, length of stay, and improved patient satisfaction, but implementation is slow without investment by hospital administration. [43][44][45] Stigma and the Patient-Physician Relationship Importantly, the stigma that health care teams often apply to nonadherent patients is rarely fair. Often, patients are nonadherent unintentionally, due to poor understanding of their symptoms and treatments, lack of awareness of how internalized feelings impact actions, limited resources, and/or treatment fatigue.…”