title: Evaluation of a Hospital-Based Pneumonia Nurse Navigator Program.
abstract: OBJECTIVE
  The aim of this study is to evaluate the effectiveness of a hospital-based pneumonia nurse navigator program.
  
  
  METHODS
  This study used a retrospective, formative evaluation.
  
  
  METHODS
  Data of patients admitted from January 2012 through December 2014 to a large community hospital with a primary or secondary diagnosis of pneumonia, excluding aspiration pneumonia, were used. Data included patient demographics, diagnoses, insurance coverage, core measures, average length of stay (ALOS), disposition, readmission rate, financial outcomes, and patient barriers to care were collected. Descriptive statistics and parametric testing were used to analyze data.
  
  
  RESULTS
  Core measure performance was sustained at the 90th percentile 2 years after the implementation of the navigator program. The ALOS did not decrease to established benchmarks; however, the SD for ALOS decreased by nearly half after implementation of the navigator program, suggesting the program decreased the number and length of extended stays. Charges per case decreased by 21% from 2012 to 2014. Variable costs decreased by 4% over a 2-year period, which increased net profit per case by 5%. Average readmission payments increased by 8% from 2012 to 2014, and the net revenue per case increased by 8.3%.
  
  
  CONCLUSIONS
  The pneumonia nurse navigator program may improve core measures, reduce ALOS, and increase net revenue. Future evaluations are necessary to substantiate these findings and optimize the cost and quality performance of navigator programs.
authors.affiliation: Author Affiliations: Student (Dr Seldon), Elizabeth P. Hanes Professor/Director, DNP Program, and Director, Population Care Coordination Program (Dr Turner), and Associate Professor (Dr Simmons), Duke University School of Nursing, Durham, North Carolina; and Senior Director (Dr McDonough), Mary Washington Hospital, Fredericksburg, Virginia.
authors.forename: Lisa E
authors.initials: LE
authors.lastname: Seldon
authors.forename: Kelly
authors.initials: K
authors.lastname: McDonough
authors.forename: Barbara
authors.initials: B
authors.lastname: Turner
authors.forename: Leigh Ann
authors.initials: LA
authors.lastname: Simmons
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006764:Hospitals, Community / Q000191:economics / Q000592:standards; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000639:trends*; D008297:Male; D062526:Patient Navigation / Q000191:economics / Q000458:organization & administration / Q000592:standards*; D011014:Pneumonia / Q000191:economics / Q000451:nursing* / Q000628:therapy; D015397:Program Evaluation; D011785:Quality Assurance, Health Care / Q000191:economics / Q000379:methods / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000191:economics / Q000592:standards*; D012189:Retrospective Studies