Welfare Reform on the Web (April 2012): Care of the elderly - overseas

Navigation roles support chronically ill older adults through healthcare transitions: a systematic review of the literature

B. Manderson and others

Health and Social Care in the Community, vol. 20, 2012, p. 113-127

Transitions between healthcare settings are difficult for patients in general and present even greater risks for older people with multiple morbidities who receive care from a long list of providers. One innovation to address this issue employs healthcare workers to facilitate safe and effective transitions across healthcare settings. These roles are commonly referred to as patient or system navigators. While a number of navigation models have been developed, there is a lack of consensus on the desired characteristics and effectiveness of this role. This literature review describes existing navigator models relevant to chronic disease management for older patients, investigates the potential impact of each model and synthesises the findings to identify common elements. It provides some evidence that navigators may be effective in assisting older patients as they transition between healthcare settings and in diverting those with serious and persistent medical conditions from higher levels of care.