Community Navigation has been a key focus area under DSRIP and began with Project 2.d.i Patient Activation that focused on training navigators across the region to use the Patient Activation Measure (PAM) to measure health literacy and assist individuals to better navigate the healthcare system. Nearly 80 partner organizations were trained on the PAM tool. In this initial project, Partners expanded their programs to address the outreach, coordination, and linkage needs of the individuals they engaged, developing a spectrum of care navigation programs based on the specialties of the Partner and needs of their population.
Since then, we launched two Community Navigation Programs and collaborated with dozens of Partners who connect individuals with food, housing, transportation, dental, behavioral health, and primary care services. These programs have demonstrated significant improvement in clinical outcome performance in the region. Further, the programs have improved collaboration between clinical and non-clinical agencies through the screening of social determinants of health and provision of culturally competent navigation services.
Community Navigation activities are critical in serving vulnerable populations. We identified six principles for a best-in-class navigation program and in the most recent program supported Partners in aligning with these principles and adopting best practices. The FLPPS Learning Management System was utilized to house program resources, e-Learnings, and other tools.