J. Heimroth1, S. Edwards1, J. Matzke3, S. Walling2, E. SUTTON1 1University of Louisville School of Medicine,Hiram C. Polk, Jr, MD Department Of Surgery,LOUISVILLE, KY, USA 2University of Kentucky School of Medicine,Department Of Surgery,Lexington, KY, USA 3Medical College of Wisconsin,Milwaukee, WI, USA
Introduction: Surgery on Sunday Louisville, Inc. (SOSL) is a nonprofit organization whose mission is to provide free endoscopy and outpatient surgery to people who are uninsured or underinsured. Two years ago, SOSL began to collect patient outcomes such as wait time from referral to consultation and wait time from referral to surgery. Seeing lengthy wait times, SOSL hired a patient navigator to attempt to improve these initial two outcomes. Our hypothesis was that a patient navigator would improve wait times by aiding patient throughout in our referral system.
Methods: Patient outcome data such as date of referral, days from referral to consultation, days from referral to surgical procedure, and dates of follow up were prospectively collected for 278 patients referred to SOSL from February 1, 2016 to June 1, 2018. The patient navigator, who spoke the primary language of the patient majority (Spanish), was hired on March 1, 2017. Data were retrospectively analyzed for the 13 months prior to her hiring (Group A) and compared to the 15 months after her hiring (Group B). Patients were excluded if they did not show up for their clinic appointment and thus had no values for inclusion. Mean days from referral to consultation and referral to surgical procedure were calculated for each group and compared using a student’s t test for normally distributed data.
Results: Patients referred before the hiring of a patient navigator (Group A, n=99)) experienced a mean wait time of 49 ± 52 days until consultation and 126 ± 98 days from referral to surgical procedure. Patients referred after the hiring of a patient navigator (Group B, n=160) experienced a mean wait time of 49 ± 51 days until consultation and 149 ± 57 days from referral to surgical procedure. Thus, there was no significant difference between days to consultation (p=1.0, 95% CI -12.94 to 12.94) between Groups A and B. There was however a significant difference in days to surgery (p=0.02, 95% CI -41.96 to -4.04) in favor of Group A.
Conclusion: Hiring a patient navigator maintained the wait time from referral to consultation, yet a navigator was not able to impact the wait time from referral to surgery in a model that attempts to delivery surgery free of charge to the patients. The impact of increased referral volume cannot be determined from this study. These results suggest another solution to lengthening surgical wait times should be sought.