Mary C. Rooney, RN, BSN, OCN, CBCN Ms Rooney described the history of navigation at Crozer Keystone Health System. In 2006, breast patient navigation began at Crozer-Chester Medical Center (CCMC). [ Read More ]
December 2012 VOL 3, NO 6
How Do Case Managers and Navigators Interface?
Ms Skinner contrasted the AONN with the Case Management Society of America (CMSA), including a description of the organizations and how they define the roles of their members. She currently believes that transitional and community-based care is often disorganized and haphazard, with patients shuffled from one postacute environment or provider to another with little advocacy and no established transitional care plan—and absolutely no idea that it should not be that way. Patients are moving from one episode of care to another without a champion to coordinate that care. This prompts a downward trajectory of their health status that can not only prompt readmissions to an acute care facility but also cause physical, emotional, and financial compromise that may interfere with the quality of the patient’s life. Patients are confused, families are in crisis, and the intervention by case managers and navigators, including members of AONN and CMSA, may be the one action that decreases anxiety and prevents negative outcomes.
Ms Skinner pointed out that the Affordable Care Act will have an effect on the practice of navigation and case management and should improve the quality and efficiency of care. She described care coordination standards and points of transition of care, which can occur within or between settings as well as across health states, eg, curative to palliative care. Each transition provides an opportunity for care coordination and a point of accountability. She emphasized that patients have to take a greater role in coordinating their care instead of assuming someone else is in charge. She also discussed the significant problem of nonadherence to medication and suggested ways of approaching it, which involve patient education and active participation.