Harris Health’s Navigation Program Checks on Possible COVID-19 Patients from Home
Annette Davis was rushing to her podiatry appointment at Harris Health System’s Baytown Health Center in May. When she arrived, the screening team took her temperature and asked her COVID-19 screening questions.
Her temperature was 100.8. While Davis attributed the temperature to not turning on the air conditioner in her car, this raised flags to the screening team. The team consulted with physicians and Davis was immediately referred to Harris Health’s COVID-19 Navigation Program.
The COVID-19 Navigation Program is a new team comprised of nurses who follow patients who have COVID-19 symptoms, but don’t require hospitalization. These teams work with Harris Health patients seen at health centers and the emergency centers from Lyndon B. Johnson and Ben Taub hospitals.
“Our goal is to follow all patients under investigation (PUI) for COVID-19 that present anywhere in our system,” says Krystal Gamarra, administrative director, Clinical Integration and Transformation, Ambulatory Care Services. “Patients are referred to us from our emergency centers and our primary care health centers.”
Davis is just one of more than 4,000 patients the COVID-19 navigator team has virtually cared for since March 26. Since that date, navigators have made 54,432 calls to these patients.
Navigators follow patients for 14 days — calling once a day if a patient is considered high-risk (elderly with co-morbidities) or three times a week if not high-risk to monitor the progression of their symptoms. During the initial call, navigators give patients a direct phone number, COVID-19 educational information, quarantine instructions and review emergency precautions.
If during the 14-days a patient experiences worsening symptoms, the navigator sets up a telehealth visit with a physician. If the patient worsens significantly and meets the hospitalization criteria (elevated fever over 100.4 degrees that can’t be resolved by medication, severe shortness of breath and chest pain), the navigator instructs them to get to the hospital as soon as possible.
“Our providers are grateful for this program,” says Dr. Matasha Russell, assistant chief of staff, Ambulatory Care Services, Harris Health, and assistant professor, McGovern Medical School at The University of Texas Health Science Center at Houston. “We don’t want to abandon our patients—we know they’re worried, and this program keeps everyone safe. The nurse navigators monitor patients’ symptoms and bring us in if a patient has a need for a virtual visit.”
Once the Baytown screening team gave Davis COVID-19 information, she returned home and followed self-isolation recommendations. A few hours later Simone Johnson, patient care coordinator, Clinical Integration and Transformation, Harris Health, called Davis and explained that she, or another nurse, would be calling her once a day to check on her.
“For many of our patients, all they know about COVID-19 is what they’ve seen on the news. Many of them are anxious they may have it,” Johnson says. “Our daily calls relieve a lot of anxiety for our patients. I enjoy being able to make a difference from a distance and that we’re able to keep patients from being hospitalized and get them on the road to recovery.”
The COVID-19 Navigation Program gives patients reassurance.
“It was so nice to have someone checking on me every day,” Davis says. “They truly spoiled me. Every time they called they asked how I was feeling, asked me to take my temperature and reminded me of what to do if new symptoms popped up—which thankfully never happened. I’m thankful my test came back negative, but I must say, I’ve missed Ms. Simone’s calls.”
The feedback from patients has been much like Davis.
“Patients have stated they are very appreciative of our program,” says Jamie Hughes, associate administrator, Clinical Integration and Transformation, Ambulatory Care Services, Harris Health. “The program gives them peace of mind during this chaotic time. They are concerned about their health, and they know they have a team behind them tracking their every symptom. And so, if an issue comes up, they’re confident we’re there to help them.”