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Navigation Support during Transitions in Care for Persons with Complex Care Needs: A Systematic Review
Lyndsay Howitt1, Greeshma Jacob1, Giulia Zucal1
1Registered Nurses' Association of Ontario, 500-4211 Yonge Street, Toronto, ON M2P 2A9, Canada.
Healthcare (Basel, Switzerland)
|September 28, 2024
Summary
Patient navigation support during care transitions may improve follow-up visits and reduce readmissions for individuals with complex care needs. However, evidence quality is very low, necessitating further high-quality research.
Area of Science:
- Healthcare Management
- Patient Care
- Health Services Research
Background:
- Individuals with complex care needs face elevated risks during care transitions.
- These needs stem from chronic conditions, serious illness, or social vulnerability.
- Adverse outcomes during transitions impact patient well-being and healthcare utilization.
Purpose of the Study:
- To systematically review the impact of navigation support on patient outcomes during care transitions.
- To inform the development of best practice guidelines for supporting complex patients.
- To evaluate effects on quality of life, emergency visits, follow-up, satisfaction, and readmissions.
Main Methods:
- Systematic review of 17 studies (2016-2023) across eight databases.
- Included studies focused on transitions from hospital to home, with navigation support lasting 1-12 months.
- Data were narratively synthesized, and evidence certainty was assessed using the GRADE approach.
Main Results:
- Navigation support showed weak indications of increasing follow-up visits and patient satisfaction.
- A potential reduction in 30-day readmissions was observed.
- No significant differences were found in quality of life or 30-day emergency department visits.
Conclusions:
- Patient navigation support during care transitions may offer benefits for individuals with complex needs.
- Current evidence is limited by very low certainty, highlighting uncertainty in effectiveness.
- High-quality research is essential to confirm the benefits and guide clinical practice.
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