Nurse Navigator Collaborative Project with the Primary Care Network
Nurse-led programs designed to follow patients with physician or medical oversight is very effective in subspecialty care. In these clinics, improvements in patient satisfaction, quality of life, cost and reductions in wait time were demonstrated. Similar innovative strategies are underway in our Division, to increase non-physician and physician shared patient care within our own service and in collaboration with the local primary care networks. The aim of these collaborative projects is to improve access, enhance waitlisted patient satisfaction, and decrease risk of adverse patient outcome while improving resource utilization.
Currently, our Nurse Navigator program is focused on expedited care for patients with dyspepsia and GERD. These are very common issues in general GI and patients currently wait up to 22 months for these issues.
Please see our clinical pathways, development of these was based on existing national and international guidelines for evidence-based care.
This pathway was first developed with the Calgary NW PCN, and began with GERD and dyspepsia, with irritable bowel syndrome pathway soon to follow. The model of care is centered around multi-discplinary care for patients: after a comprehensive assessment by the lead nurse by telephone, the patient is booked for a group appointment. Here there is a pharmacist, nutritionist, possibly behavior health consultant, the GI nurse and GI physician. After the group meeting, where ideas and health education is shared, (limited personal health information, just general symptoms) the patients are seen individually by either the GI-interested family physician or the GI specialist. Follow up occurs mostly by telephone but additional tests may be ordered at that time.
In addition to nurse-led streams of care, we are increasing our capacity for non-sedated upper endoscopy (thin scope endoscopy or TSE) with the use of very thin, flexible scopes. These scopes can be used to fully examine the upper GI tract, similar to a conventional gastroscope, equipped with the capacity to take biopsies. The advantages are clear, as it requires no sedation or recovery and can be done in an outpatient setting, so it is less expensive. Ten of these procedures can be done in one half day (20 procedures per full day) and therefore, we hope this will improve access to endoscopy in patients appropriate for this evaluation.
If you have questions or concerns about the Nurse Navigator pathway, please contact:
Colleen Johnston: 1-403-944-6459
Or email at: email@example.com