Date of Conferral
12-30-2025
Date of Award
December 2025
Degree
Doctor of Nursing Practice (DNP)
School
Nursing
Advisor
Sue Bell
Abstract
Walden University College of Nursing This is to certify that the doctoral study by Bernadine Grinage has been found to be complete and satisfactory in all respects, and that any and all revisions required by the review committee have been made. Review Committee Dr. Sue Bell, Committee Chairperson, Nursing Faculty Dr. Diane Whitehead, Committee Member, Nursing Faculty Chief Academic Officer and Provost Sue Subocz, Ph.D. Walden University 2025 Abstract The practice issue cited by clinical staff of a rural mental and behavioral clinic (RMBHC) was fragmented versus holistic care, increase emergency room (ER) visits, inadequate access and patient attrition rate to specialized psychiatric and collaborative multidisciplinary healthcare. These factors negatively impact quality patient outcomes such as increased morbidity, mortality and quality of life (QOL) as well as astronomical healthcare cost. The research problem aims to mitigate the practice issue by increasing staff perception that the utilization of a Care Navigator (CN) is an integral member of the health team to address barriers and enhance facilitators of mental and behavioral patients for timely access to required services that improve quality outcomes. This quality improvement (QI) utilized literature review of 10 scholarly articles inclusive of qualitative, quantitative, mixed and random control trial (RCT) research as well as one opinion paper. Contributory evidence was obtained from the performance of project management (PM) tools such as critical stakeholder analysis and selection, SWOT (strength, weakness, opportunity, threat) and organizational readiness and comparative clinical site analyses. An assessment of staff knowledge and perception of CN roles/responsibilities inclusive of a survey post a 20-minute staff education PowerPoint presentation. These cited activities will provide the supportive evidential data that will improve staff perception on the importance of a CN as apart of the health team at the RMBHC for provision of holistic, collaborative, timely access and quality outcomes in the management of mental and behavioral patients. The assessment of staff perception was measured at 8.73 using a percentile knowledge gain score (KGS) with the administration of pre and posttest questionnaires. The staff participation attrition rate was 18.18% as 2 of the 11 tests were rejected due to incompletion. This QI project resulted in the positive buy-in process of critical stakeholders and staff to need of the CN as an integral part of the care management of the cited patients for holistic , collaborative and timely access to psychiatric , medical and social services and decrease healthcare cost.CN utilization will mitigate the identified health practice issue not only to improve patient QOL but prevent inappropriate ER use , decrease morbidity and mortality with cost saving healthcare expenditure for public health campaigns e.g. stigmatization, peer/patient support and mental and physical health literacies.
Recommended Citation
Grinage, Bernadine, "Care Navigator Role in the Management of Patients' Access at a Mental and Behavioral Health Clinic" (2025). Walden Dissertations and Doctoral Studies. 18762.
https://scholarworks.waldenu.edu/dissertations/18762
