Abstract
Purpose. The current healthcare system is designed with highly structured and multifaceted patient care protocols that are difficult to understand, maneuver, and manage. Consequently, the complexities of the healthcare system present barriers to timely and quality health services for many individuals, especially those who suffer from a chronic disabling condition. The challenges are intensified for individuals who have sustained a traumatic brain injury (TBI) due to the associated long-term disabling cognitive impairments. The purpose of this study was to evaluate the implementation of Casa Colina Hospital's (CCH) patient navigation program (PNP), which aimed at assisting TBI survivors to navigate the healthcare and social service systems they are forced to interact with and to analyze the outcome results of this program. Theoretical Framework. A summative program evaluation framework was utilized to guide the findings of this research. This type of evaluation includes an assessment of both, implementation of an established program and on program outcomes (Owen & Rogers, 1993). Additionally, a review of implementation literature guided the analysis of implementation of the PNP. Methodology. The design of this research is in the form of a case study, which includes qualitative and quantitative data analysis. The case study design seeks to understand the implementation of CCH's PNP. Yin (2009) asserted that the aim of a case study is to understand complex social phenomena. A review of CCH patient navigation program proposal and structured interviews were used as qualitative sources. Quantitative analysis included participant outcomes and number of contacts made with program participants. Findings. This evaluation found that various adaptations were made to the PNP during implementation. Findings also suggest that the measured program outcomes (e.g., rehospitalizations, falls, BDI-II, NSI, TBI-QOL, CHART) were impacted by implementation of the PNP. Lastly, it did not appear that the intensity of patient navigator contact with participants was significantly correlated with the overall measured outcomes. Conclusions and Recommendations. Results of this evaluation indicated that the use of a patient navigator for survivors of a TBI can positively impact participant outcomes in some measured outcome areas. However, future research should include a larger sample to allow for more advanced statistical analysis to test the efficacy of the PNP for TBI survivors and other medically complex populations.