Navigating Rough Waters: Achieving Excellence with a Nurse Navigator at the Helm

Purpose:
An orthopedic nurse navigator role was developed to: Provide orthopedic resources for physicians, staff, and patients. Coordinate the care of orthopedic inpatients and facilitate achievement of goals and quality outcomes. Provide orthopedic education for staff, patients and families.

Significance:
The orthopedic nure navigator role provides significant impact in achieving measureable quality outcomes that are patient centered, safe, and effective. Staff and community were also positively impacted through the educational components.

Strategy and Implementation:
A comprehensive evaluation of the surgical orthopedic patient experience was conducted which resulted in identification of areas for improvement such as patient satisfaction, physician satisfactiion, length of stay, pain management and core measures. The RN Nurse Navigator role was designed to provide a single point of contact for orthopedic surgeons, hospital staff and patients. The strategy provides continuity of care for patients pre, during and post hospitalization. Focus is on achievement of quality outcomes for the patient and efficiencies for the Hospital. The Nurse Navigator is the expert resource for all customers with orthopedic needs which includes any orthopedic patient admitted to the hospital for surgery, the hospital staff, and the community. The role also provides significant nursing input into the marketing of orthopedic services, identification of program needs and the expansion of the orthopedic service line.

Evaluation:
Implementation of the nurse navigator role had the following results: Increased patient and physician satisfaction. Decreased length of stay for joint replacement and hip fracture patients. Decreased pain levels at discharge. Improvements in Core Measures outcome data.

Implications for Practice:
The success of this role demonstrates how essential the utilization of expert nurses is to achieving quality patient outcomes and efficient, effective organizational outcomes. Additional roles have been developed for other surgical patients and for medical patients.