Good for patients, good for our health system

When the Palaszczuk Labor Government committed to funding 400 Nurse Navigators back in 2016, we were thrilled our years of lobbying had finally reaped rewards.

As nurses and midwives, we know many of our patients find it challenging to navigate the complexities of the health system, that they can struggle to fully understand their care, or might feel overwhelmed by it when they are feeling vulnerable and anxious.

We have long recognised the important role Nurse Navigators can play in helping these patients steer their way through the fog to get the best out of their healthcare.

Last month the Office of the Chief Nursing and Midwifery Officer (Queensland) released a new report which indicated just how critical the Nurse Navigator program has been over the past seven years, the data showing impressive outcomes both for patients and the health system more broadly.

The Central Queensland University Australia (CQU) study, conducted in Queensland Hospital and Health Services (HHS) state-wide between 2018 and 2021, found Nurse Navigators improved quality of life, reduced Emergency Department stays and saved Queensland taxpayers $110 million a year.

The Queensland Health Nurse and Midwife Navigator Evaluation Report also found Nurse Navigators reduced patient hospital stays by 3.2 beds days per patient and reduced readmission rates by 6%.

The cost and resource savings are certainly worth applauding, but the personal impact on patients and their care outcomes are equally noteworthy.

The report, which surveyed 7000 Queensland Health patients across the state, found Nurse Navigators significantly improved patient’s health literacy and helped patients feel more empowered to make decisions about their care.

Patients reported having an improved quality of life and an increased sense of general wellbeing and control following engagement with a Nurse Navigator.

For QNMU member and Disability Nurse Navigator Greg Parrott this kind of positive patient response is what makes his work worthwhile.

“Being a Nurse Navigator is an incredible role and I love it,” he said.

“I love getting to know patients and getting to see and guide them through a bit of their healthcare journey.”

A Nurse Navigator at the Princess Alexandra Hospital in Brisbane for more than five years, Greg says he is pleased the report documented the value of Navigator engagement from a patient perspective and said supporting patients to grow confidence as active participants in their own care is hugely rewarding.

“It makes you feel good, because you know you’ve accomplished something and made a real difference to someone’s life,” he said.

Nurse Navigators work directly with patients with chronic or complex health conditions to assist and streamline their health journey and enhance care co-ordination and condition management… (They) support and work across system boundaries and in close partnership with multiple health specialists and health service stakeholders to ensure patients receive the appropriate and timely care needed.

Queensland Health

“My role involves working with patients in the hospital (and) in the community to try and help them build their capacity to better manage their healthcare needs,” he said.

“I do a lot of visiting primary healthcare services with the patients to try and improve that relationship, and a lot of working with carers and families to help improve health literacy.”

“If you can deliver health literacy education at somebody’s level, you can actually get some buy-in…to help improve their health outcomes.”

Greg said being a Nurse Navigator allows him to work more completely to his full scope of practice, to draw on a broad skillset to deliver a highly personalised level of care not always possible in a standard clinical setting.

“As an example, I had a patient who was referred to me from a GP because he was taking too much Panadol. The patient had a background of intellectual impairment and he refused to stop taking Panadol because he had back pain.”

“In his mind…if some Panadol is good, more must be better. Because I already had a relationship with the patient, I was able to go out to his home, look at what was causing his back pain, deliver some education to him about Panadol and why we take it and why we don’t.

“I also looked at his bed - he was actually sleeping on two mattresses stacked on top of each other, so he didn’t have any proper (spine) support – so I went through a community organisation and got him a new bed.”

“With the new bed and the education, he now no longer overdoses on Panadol - his back’s no longer sore and it means we won’t see him in a couple of years in the hepatology clinic.”

The Evaluation Report offers irrefutable evidence about the value of Nurse Navigators and will be put to good use as the QNMU continues to press for an expansion of the Nurse Navigator approach as part of the Federal Government’s Medicare reforms.

The government outlined its plans for reform in the Strengthening Medicare Taskforce Report released on February 3 which recommends significant changes to how primary care is funded and delivered to ensure high quality, integrated and personcentred care for all Australians into the future.

The QNMU welcomed the report for recognising the important role nurses and midwives should play in a revised Medicare scheme, and for providing scope for greater nursing and midwifery leadership in healthcare.

“The next iteration of Medicare must focus on unleashing the potential of nurses and midwives,” QNMU Secretary Beth Mohle said.

“A reformed Medicare system must ensure all health workers can work with the community to better co-ordinate their care based on patient needs.”

Nurse Navigators are well positioned offer nurse-led, patient-centred care in the community and Greg says there is no shortage of demand.

“Just in the space I work in, one in 20 people in Metro South have a significant, profound disability and there are not enough nurses to provide that level of support,” he said.

“There’s way more need than resources at the moment so expanding the Nurse Navigators workforce would be a win-win, particularly into those areas that are (currently under-serviced) like mental health nurse navigators or psychosocial disability nurse navigators – we also really need more homeless nurse navigators … I don’t think we can ever have enough.”

In addition to the Medicare Reform process, the Evaluation Report also provides an evidencebased underpinning for the ANMF’s recommendations in the 20232024 Pre-Budget Submission to the Federal Government, which calls for the introduction of Aged Care Nurse Navigators and ring-fenced funding to “trial, evaluate and scaleup” innovative and multi-disciplinary models of care in the health system, including Nurse Navigators.