Impact of nurse practitioner navigation on access to care for patients with refractory gastroesophageal reflux disease.

Abstract

BACKGROUND\nGastroesophageal reflux disease (GERD) is a common digestive complaint that can negatively affect patients quality of life and have serious complications if inadequately treated.\n\n\nLOCAL PROBLEM\nFacilitating prompt and efficient access to digestive care is imperative especially given the current burden of gastrointestinal diseases such as GERD.\n\n\nMETHODS\nA clinical team conducted a quality improvement study in which a nurse practitioner (NP) navigator performed a preconsultation chart review for patients with refractory GERD referred to an Esophagus Center between August and December 2018.\n\n\nINTERVENTIONS\nBased on preconsultation chart review, the NP navigator arranged for diagnostic testing and follow-up. Days from consultation to testing completion and establishment of plan were tracked and compared with historic controls. The NP navigator documented time spent for chart review and care coordination.\n\n\nRESULTS\nThe median number of days from consultation to testing completion for patients who underwent NP navigation and required diagnostic testing (n = 26) was 33.5 as compared with 64.5 for historic controls who required testing but received usual care (n = 28) (p = .005). The median number of days from consultation to establishment of a management plan was 52 for patients who underwent NP navigation as compared with 97 for historic controls who did not (p = .005). The mean amount of time spent by the NP navigator for chart review and care coordination was 17.5 min (n = 30).\n\n\nCONCLUSIONS\nIncorporation of NP navigators into gastroenterology practices offers a potential solution for timelier patient care delivery.