Welcome to Patient Navigation!
What is a patient navigator? That is someone who provides guidance to patients as they move through the health care system, helping their patients to access resources that speed the delivery of treatment and follow-up care. The Patient Navigator may at times guide patients through and around barriers to their care which might include financial barriers (insufficient health insurance); educational barriers (inadequate health literacy); transportation barriers (a need for dependable private or public transportation); and any life circumstance that impedes a patient's access to timely treatment and follow-up care.
Dankmeyer is working on defining a Patient Navigator role. That person will seek to provide resources which might include lists of private and non-profit organizations that may help; written information regarding support groups and other community organizations; and educational materials that serve to increase a patient's health literacy. Patient Navigators also develop relationships with individual staff at local healthcare, government, and non-profit organizations, who may be of service to his/her patients. On an as-needed basis, the Navigator connects particular patients to particular staff at these organizations to expedite the problem solving process.
We frequently receive requests to provide our new amputees with driver information and resources. Many new patients are unaware that they are legally obliged to self-report their medical conditions to the Motor Vehicle Administration (MVA), to have their cases reviewed by a medical advisory board, which is charged with evaluating their medical fitness to drive. We provide these patients with a summary of the MVA's requirements, contact information for the MVA's Driver Wellness and Safety Division, as well as a list of local driver rehabilitation programs and adaptive driver equipment suppliers. As patients most often endure long waits to receive the results of their MVA medical evaluations, we advise them to consider completing a driver rehabilitation program while waiting for their medical review results; this way, their certifications are at the ready upon receiving word from the MVA. This information serves to significantly shorten the amount of time it takes to get our patients back on the road.
Some patients are challenged by life circumstances that disrupt their treatment plans and threaten their long term help. There are other resources that we can provide to try and smooth a patient’s way through their own health care system . These are listed below.
Links to resources you may be interested in:
- Amputee Driver Requirements and Resources
- National Highway Traffic Safety Administration - Adapting Motor Vehicles for People with Disabilities
- Amputee Resources, Support Groups and Adaptive Sports
- Community Mental Health Centers - Baltimore County & City
- Home Modification & Assistive Tech - Baltimore County & City
- Insurance and Financial Assistance
- Medicaid Transportation By County
- Medicare and Medigap Supplemental Insurance
- Social Work and Case Management - Baltimore County & City
- Transportation Services - Baltimore County & City
Certified Peer Visitors from Amputee Coalition
The Amputee Coalition's Certified Peer Visitor (CPV) program grew out of the belief that "no one is in a better position to understand the challenges of living life with an amputation, and to support a person with limb loss, than someone who has been there."
The Amputee Coalition's CPVs are trained volunteers who provide information and support for individuals about to undergo amputations, individuals who currently have limb loss, as well as amputees' family members. All CPVs must successfully complete an 8 hour training course, typically conducted at Amputee Coalition partner hospitals/ rehabilitation facilities or at amputee support group sites. The CPV training teaches applicants to recognize the elements of recovery from amputations, and how to respond with helpful interventions during different phases of emotional adjustment. CPVs utilize time-tested listening and dialogue-building techniques that enable them to offer encouragement and practical information from a place, and at a pace, that eases an individual's physical and emotional transition to life as an amputee.
For many new amputees, the psychological impact of amputation is just as significant as the physical challenges. A negatively impacted body image, damaged self-esteem due to work loss, and the feeling that one's quality of life has been forever diminished, are just a few of the damaging mindsets that many new amputees contend with. Recognizing the positive difference CPVs can make in the lives of amputees, and aware of the shortage of CPVs serving our local limb loss community in Maryland, Dankmeyer's leadership recently sponsored a CPV group training session at the June 15, 2016 Amputee Walking School event at the University of Maryland Rehabilitation and Orthopaedic Institute. While thirteen new CPV applicants/ trainees await their test results, Dankmeyer is investigating the most effective ways to utilize this newly expanded group of Maryland-based CPVs. One idea under consideration is to offer peer visits to all of our new amputee patients, with the hope that these visits will help Dankmeyer to more quickly identify and begin to help individuals who are having difficulty adjusting to their recent limb loss. As CPVs are uniquely equipped to provide both empathy and needed coping strategies for new amputees, Dankmeyer's hope is that peer visits at the onset of our patients' prosthetic services will lessen the potential for despair among our most vulnerable new patients.
Anyone who has had an amputation, is scheduled to have an amputation, or was born with limb loss, may request a Peer Visit at any time from one of the Amputee Coalition's CPVs. To request a visit, simply contact the Amputee Coalition via the Amputee Coalition's toll-free telephone number or the link below:
888-267-5669 / extension 7 for Amputee Coalition Peer Support
Dankmeyer patients who wish to have a Peer Visit are also encouraged to let their prosthetist know.
A Brief History of Patient Navigation:
The concept of Patient Navigation was founded and pioneered by Dr. Harold P. Freeman at Harlem Hospital in 1990. Dr. Freeman founded the first Patient Navigation program to provide his low-income patients with "personal guides" through the healthcare system. The success of this initial program, as evidenced by dramatically improved health outcomes, prompted the passage of the "Patient Navigator, Outreach and Chronic Disease Prevention Act" in 2005. This legislation provided $25 million in funding to implement Patient Navigation programs nationally. Here is a link is for the Harold P. Freeman Patient Navigation Institute, an organization that provides Patient Navigation resources and training, and which is headed by Dr. Freeman himself. This is perhaps the best online resource to learn more about this growing profession: www.hpfreemanpni.org
The June 2016 Amputee Coalition Convention
The Amputee Coalition's 2016 National Conference was a huge success, setting an attendance record, with a total of 1,075 attendees. This annual conference embodies the Amputee Coalition's mission: "to reach out and empower individuals affected by limb loss to reach their full potential through education, support and advocacy, and to promote limb loss prevention."
This year's national conference addressed a myriad of topics of interest to the entire limb loss community, not only for individuals living with limb loss, but also for caregivers and the families of amputees, as well as healthcare professionals. One series of sessions addressed living with particular levels of limb loss, while a series of "roundtables" addressed the particular needs and concerns of amputee men, women, children and their parents, caregivers, and the amputee LGBQTI community. Other sessions addressed developing amputee life skills, managing chronic illness, coping with the psychosocial aspects of amputation, new prosthetic technology, self-advocacy and self-management skill building.
Among the sessions was an introduction to the "Promoting Amputee Life Skills (PALS)" program - a program that was developed by Stephen Wegener, PhD, a rehabilitation psychologist and senior faculty member at Johns Hopkins. This 8-lesson program is designed to develop skills to improve the quality of life for people living with limb loss, emphasizing the learning and practice of self-management skills, such as problem-solving, goal-setting, communication and relaxation. An online version of this program will soon be launched and could be offered to Dankmeyer's new patients to help them cope with the practical and emotional challenges of recent limb loss, and to rethink and reclaim their activities of daily living.
Another session entitled "Why It Pays to Keep Active and Engaged", also provided amputees with strategies for self-management and overcoming psychological barriers. The importance of peer support was emphasized by this session's leader with the following quote from an amputee: "Friends and family care a lot. Doctors, nurses and therapists have invaluable expertise. But as caring or as expert as these individuals are, they cannot understand what it's like to lose a limb unless they've experienced it themselves." This sentiment was repeated several times. For this reason, increasing the number of Certified Peer Visitors in our geographic area is a good idea that will serve our new patients well.
One of the sessions that also stood out was the "Parents/ Pediatrics Roundtable." This session was led by two representatives of the Association of Children's Prosthetic-Orthotic Clinics (ACPOC), a healthcare organization that serves as a comprehensive resource for treatment options provided by professionals who serve children, adolescents, and young adults with various orthopaedic impairments. For a number of the parents who attended this session, this was the first opportunity they had to meet and compare child amputee "parenting notes" with other parents of children with limb loss, and it became clear that effective parent peer support groups for the limb loss community are in short supply throughout the country.