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Monica Nandwani, DNP'19, and Eleanor Stevenson, Professor, received The Stanford Health Care winning submission for their publication entitled "Impact of Nurse Practitioner Navigation on Access to Care for Patients with Refractory Gastroesophageal Reflux Disease."  This award was part of the first Stanford Medicine Center for Improvement Award for Excellence in Improvement Publications. The purpose of the awards was to encourage and to celebrate publication of papers describing improvement efforts and to encourage interdisciplinary collaboration.

Co-authors included John O. Clarke, MD, Stanford University School of Medicine.

Abstract

Background: Gastroesophageal reflux disease (GERD) is a common digestive complaint that can negatively affect patients’ quality of life and have serious complications if inadequately treated.

Local problem: Facilitating prompt and efficient access to digestive care is imperative especially given the current burden of gastrointestinal diseases such as GERD.

Methods: A 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.

Interventions: Based on preconsultation chart review, the NP navigator arranged for diagnostic testing and followup. 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.

Results: The 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).

Conclusions: Incorporation of NP navigators into gastroenterology practices offers a potential solution for timelier
patient care delivery.

Citation

Nandwani, M., Clarke, J. O., Kuriakose, C., & Stevenson, E. (2019). Impact of nurse practitioner navigation on access to care for patients with refractory gastroesophageal reflux disease. Journal of the American Association of Nurse Practitioners. https://doi.org/10.1097/JXX.0000000000000296