Hip and knee patient navigator: Moving people past the fear

Katya Gonzales

Katya Gonzales, a Patient Navigator dedicated to Hip and Knee Care at North York General Hospital (NYGH), knows just how to put patients at ease, by giving them the right information at the right time. Even though hip and knee joint replacement surgery are two of the most commonly performed procedures in Ontario, for each individual patient it’s a lot to learn about and prepare for.

“Many of the patients I meet are initially scared of experiencing pain following surgery and are very concerned about how they are going to manage at home,” says Katya. “As their patient navigator, it’s my job to provide them with information and support in hospital and at home so that they go into their surgery feeling calm and confident they are prepared for their recovery.”

Katya is a registered nurse and sees her navigator role as dynamic because it allows her to build trusting relationships with patients over the course of their journey, solve problems and use evidence based information to help patients and families understand their care. Several other programs at North York General have patient navigators to provide continuous support, including the Breast Cancer Care Program and Colorectal Cancer Program.

NYGH is home to the innovative Total Joint Assessment Centre (TJAC), which provides patients with quick and easy access to a consultation and assessment for hip or knee surgery. Our orthopaedic surgeons have extensive expertise and perform innovative procedures such as anterior hip replacement surgery, which is only available at a few hospitals in Ontario.

Hip and knee care can be complex, and patients may be seen at the hospital at various phases, the patient navigator provides familiarity, consistent support and security. Katya is a single point of contact for patients to ask questions, arrange appointments and connect with resources in the community. When patients don’t have access to a patient navigator it places a significant burden on them and their families to figure out who to call about their concerns. Following surgery, it prevents emergency department visits, when patients are not able to reach their family doctor or surgeon.

At NYGH the Hip and Knee Patient Navigator is involved with all aspects of the patient journey including:

  • Listening to and addressing concerns pre and post-operatively
  • Explaining the steps to prepare for before surgery and recovery e.g. arranging your home so that everything is on one floor, having their equipment ready, putting things in easy to reach places, preparing meals ahead of time
  • Following-up with patients after they go home
  • Coordinating services e.g. inpatient rehab or home care services
  • Preparing referrals for outpatient physiotherapy
  • Coordinate appointment with surgeons at the Ortho Plastics Clinic and homecare services, if needed
  • Helping arrange transportation, filling out Wheel - Trans applications
  • Connecting with community resources – e.g. Meals on Wheels

Throughout the course of the day Katya will meet with patients in the Pre-Op Assessment clinic, inpatient unit, rehabilitation class or speak with them over the phone. Timely care is always a priority for her, and she considers it a great day when she can help answer questions and resolve concerns while collaborating with all members of the care team.

"I think of the navigator role as a personal guide who helps connect the different providers and the right services to the patient," says Katya. "It's very rewarding to partner with patients in a way that empowers them during their recovery and gratifying to see how happy they are to discover how well they can manage at home." 

Before going home, your care team will:

  • Make sure your pain is manageable
  • Ensure you are walking
  • Able to climb stairs
  • Able to transfer to a bed, chair, bathroom and shower

Learn more about the NYGH Hip and Knee Care and the Total Joint Assessment Centre. The centre provides patients with an early consultation for assessment and diagnosis for hip or knee replacement surgery.  A patient should receive an appointment with TJAC within two weeks of the referral. On the first visit, a patient is assessed by a clinician — an experienced orthopaedic nurse or physiotherapist. A comprehensive assessment includes physical, social and lifestyle status. Patients identified as surgical candidates will move on to see an orthopaedic surgeon at a second visit to finalize the decision

NYGH is proud to have the best wait times for hip and knee surgery (from decision to treat to treatment) in Ontario for the sixth year in a row.

This article first appeared in the February 2020 issue of The Pulse.

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