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'Navigator' Helps ER Patients Who Don't Need Emergency Care

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Each week, Weekend Edition Sunday host Rachel Martin brings listeners an unexpected side of the news by talking with someone personally affected by the stories making headlines.

Wendy Shindler, a nurse, works in the waiting room of New York City's Montefiore Medical Center's emergency department, where she identifies patients waiting for services who don't actually need emergency room-level care. The program is an intervention aimed at improving care at the busy Bronx hospital while reducing costs.

"The ER was admitting everybody, and they weren't getting paid — Medicare wasn't paying them for everything," Shindler tells NPR's Rachel Martin. "And they said, we have to figure out a way to help the community so they can stay out of the hospital." So, Shindler, who had ER and case management experience, became the hospital's patient navigator.

Not everyone was on board with the change at first. "The doctors in the emergency room, they were concerned because they thought they needed to admit everybody," says Shindler. Obviously, there's a liability concern when a patient with chest pains is referred to a cardiologist the next day, instead of being admitted.

"What I did was, I gave them feedback from the cardiologist the next day," says Shindler, "and said, 'Listen, the patients did go and they're getting good care and they're doing OK in the community.'" And, she points out, the patients were happier, too.

After about a year and a half, the doctors came around. "I still remember when they said to me, 'Wendy, you're part of the team. You made it. We see what you can do for us.'"

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