By Thomas Cleare, PhD, MBA
Vice President of Strategy, Health Care District of Palm Beach County
I recently had the distinct honor of “walking in the shoes” of two of our team of exceptional Patient Navigators at the C. L. Brumback Primary Care Clinics, Marco Meneses and Ingrid Bartlett.
I was able to see first-hand the very important role Patient Navigators have in the care provided to patients at the Brumback Clinics. This level of education, counseling, and care coordination is critical to achieving positive outcomes with our patients.
Very often, patients who live with chronic conditions or who require important preventive medicine testing, benefit from the assistance, guidance, and compassionate voice from a Patient Navigator to help them understand their medical situation and learn to take control of their medical care.
Patient Navigator, Lantana Clinic
I started my day joining Marco Meneses at the Lantana Clinic. He explained that the concept of the patient navigator was originally founded and pioneered by Harold P. Freeman in 1990 for the purpose of eliminating barriers to timely cancer screening, diagnosis, treatment, and supportive care. Marco explained that the patient navigation model has been expanded to include the timely movement of an individual across the entire health care continuum from prevention, detection, diagnosis, treatment, supportive, and end-of-life care.
Marco works with patients with uncontrolled diabetes, uncontrolled high blood pressure, and/or depression. The day I visited with Marco I was fortunate to sit with him while he met with a patient. Marco began the meeting by conducting a medication reconciliation with the patient.
The patient was asked to bring his medications with him to the visit. Marco then asked the patient to identify each of the medications he takes – what it is for, the strength of the medication, the instructions for taking the medication, whether the patient is taking it as prescribed, and whether it is time for any refills. The short medication reconciliation is very important to help ensure medication compliance and that the patient understands the importance of each medication.
Marco also reviewed the action plan for the patient. This is where the Patient Navigator can provide some counseling and education and explore how the patient is doing emotionally, whether anything is bothering the patient, whether they are able to stay active, whether they are practicing healthy food choices, and whether they are able to reduce stress and quit smoking.
This is where a patient navigator is able to really build a relationship with the patient. I could clearly see that this patient felt Marco truly cared for him and was trying to help him manage his diabetes.
Marco uses practical materials and tools to explain and demonstrate ways to cook and eat healthier foods.
Marco also helps his patients understand how to identify foods with fewer sugars and carbohydrates that could be substituted for less healthier options.
In addition to serving in a fascinating role for the Brumback Clinics, Marco, has also had exciting experiences having served as a United Nations Volunteer in Honduras, Equatorial Guinea, Angola, Sudan, Egypt and Somalia. Marco’s work in health care included working in Somalia for World Vision International as a Health Officer.
While there, Marco suffered in a terrorist attack when a 40 kilogram plastic explosive detonated in his compound and nearly killed him. Marco also has prior experience as an Addiction Counselor at a Central Florida Treatment Center for Opioid Addiction as well as experience in Chronic Disease Prevention.
Marco, born in Colombia, has lived in Florida for the last 11 years where he and his wife are parents of a 9 year old boy named Marco who is in third grade.
Patient Navigator, Colorectal Cancer Screening Project
For my next stop, I had the privilege to visit with Ingrid Bartlett, who serves as Patient Navigator for the Brumback Clinics’ colorectal cancer prevention program, which was recently recognized by the American Cancer Society’s National Colorectal Cancer Roundtable as an Honoree recipient of the 2017 “80% by 2018” National Achievement Awards for having one of the highest screening rates among community health centers in the country.
The success is due in part to the key role Ingrid plays in the open access colonoscopy protocol. The prevention program identifies adults age 50 and older for colorectal cancer screening using fecal immunochemical tests (FITs). Ingrid begins to build rapport with candidates by explaining, in common language, what the test is, how it is performed, and what to expect. She quite literally walks side by side with patients throughout the entire process.
After the screening test, Ingrid personally follows up with patients regarding their test results. If the test indicates that a colonoscopy should be performed as a higher level of screening, Ingrid helps the patient schedule the colonoscopy. She assists the patient in understanding the test-prep procedures and is available by phone with any questions the patient may have after they have left the clinic.
On the day of the procedure, Ingrid meets the patient at Lakeside Medical Center, providing support both before and after the procedure. This high level of comfort has been important to improve success with the pre-test prep and overall compliance. Ingrid’s intensive approach to patient navigation has helped the Clinics increase their colorectal cancer screening rate among age-eligible patients from 37% in 2014 to 75% in 2016.
In addition to serving in such a dedicated patient navigation role, Ingrid has an equally interesting story. She was born in Slovakia, formerly Czechoslovakia, where she graduated with a Master of Science in Banking and Investment. Her love for health care came later when she started working as a registration specialist with the Department of Health.
Having no formal clinical education, Ingrid has dedicated herself to her career and the patients she helps by learning the necessary skills to care for and support her patients. Her compassion plays a big part. Ingrid says her biggest reward is when she receives a big hug from the patient and the knowledge that we did everything what was in our power to meet the patient’s needs.
I would like to thank both Marco and Ingrid for spending some time with me. But most importantly, I would like to thank them for the exceptional service they provide to the patients of the Brumback Clinics.
Thomas Cleare, PhD, MBA is the Health Care District’s Vice President of Strategy. Read his bio.