title: Impact of an innovative inpatient patient navigator program on length of stay and 30-day readmission.
abstract: BACKGROUND
  The current climate of increasing patient complexity coupled with rising costs have prompted the need for adaptive innovation. There are limited data describing inpatient interventions targeting improvements in both communication and transitional care.
  
  
  OBJECTIVE
  Evaluate the patient navigator (PN) program, an innovative inpatient intervention intended to enhance navigation through the complexity of hospital admissions for patients and providers.
  
  
  METHODS
  PNs were dedicated patient-care facilitators without clinical responsibilities integrated as full members of the inpatient care team responsible for enhancing communication between and among patients and providers.
  
  
  METHODS
  Observational retrospective cohort study.
  
  
  METHODS
  All patients admitted to the general medical service between July 2010 and March 2014.
  
  
  METHODS
  Academic medical center.
  
  
  METHODS
  Primary outcomes were hospital length of stay (LOS) and 30-day readmission rate matched by case mix group, age category, and resource intensity weight.
  
  
  RESULTS
  Our matched cohort included 5628 admissions (4592 patients) exposed and 2213 admissions (1920 patients) not exposed to PNs. Admissions with PNs were 1.3 days (21%) shorter than admission without PNs (6.2 vs 7.5 days, P < 0.001). Thirty-day readmission rate was not different between the 2 groups (13.1 vs 13.8%, P = 0.48).
  
  
  CONCLUSIONS
  Implementation of this intervention was associated with a reduction in LOS without an increase in 30-day readmission.
authors.affiliation: Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.|Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Janice L
authors.initials: JL
authors.lastname: Kwan
authors.affiliation: Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.|Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Matthew W
authors.initials: MW
authors.lastname: Morgan
authors.affiliation: Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Department of Medicine, Niagara Health System, St. Catharine's, Ontario, Canada.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Stewart
authors.affiliation: Department of Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada.|Department of Medicine, University of Toronto, Toronto, Ontario, Canada.|Institute for Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007297:Inpatients; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D062526:Patient Navigation / Q000379:methods* / Q000639:trends*; D010359:Patient Readmission / Q000639:trends*; D012189:Retrospective Studies