Today, Doyle cares for Rosie, a bichon frise with an attitude, and Alex, a 25-year-old Egyptian Arabian horse with cataracts.

She also helps care for scores of surgical patients treated for back and neck procedures in the Department of Neurosurgery; for trauma patients treated in both Neurosurgery and the Department of Orthopaedics; for patients having small and large bowel surgical procedures; and for patients undergoing total joint replacements.

As the program manager of the Surgical Navigator Program, Doyle and the other "navigators" adapted the successful Care Management Program model (CMPUI) designed to improve patient satisfaction, patient care coordination, and discharge planning.

Working closely with social workers Jean Teale, Lynn Dee Sheridan, nurse Sue Bouslog, and secretary Stacy Tompkins, Doyle and the surgical navigator team work with faculty and residents to positively affect length of stay and enhance compliance with the 11 a.m. discharge policy. The results of their efforts include improved faculty and staff satisfaction in addition to improved patient satisfaction.

In hospital jargon, the group’s work is focused on "throughput"–a word borrowed from computer lingo that refers to the amount of work a computer can do in a given time period. The concept takes into account productivity, performance, and effectiveness. Computer experts will say that the key to high throughput is the efficient use of available resources, and that principle is the crux of the surgical navigator program at University of Iowa Hospitals and Clinics.

"We meet patients pre-operatively," Doyle explained. "We try to identify their discharge needs and assess their level of psycho-social support. We look at their financial issues and their options for home care. Then, we look at our resources and work very closely with the staff on the units as well as with appropriate community professionals to help manage our patients’ care before, during, and after their surgery."

Since January, approximately 300 patients have been served through the program. The clinical initiative has been funded for two years.

"Our job is to maximize the system to improve throughput. We collect the barrier data and, with the assistance of other professionals, we are able to provide solutions to the care management problems of this particular group of surgical patients," Doyle said.

Data is collected and monitored on the following outcomes: length of stay, satisfaction of staff and patients, 11 a.m. discharge achievement rate, and other regional and national benchmarks.

The program is under the direction of Linda Everett, PhD, RN, associate director and CNO; with assistance from Barbara Muller, MD, medical director of CMPUI; and Jay Cayner, associate director and CMPUI administrator.

Surgical Navigator Program
The Surgical Navigator Program is a pilot program designed to create system changes that enhance the throughput of select surgical patient populations. The program is under the direction of Linda Everett, PhD, RN, Cindy Doyle, ARNP, Barbara Muller, MD, and Jay Cayner.

Program Goals

• Focus on patients and families with complex discharge issues.
• Focus on system and institutional barriers that influence satisfaction and utilization management.
• Negotiate, coordinate, and procure services needed to expedite safe and timely discharges.
• Monitor outcomes for team learning and identification of best practices.
• Build relationships and develop networks to achieve expected length of stay, as well as patient and staff satisfaction.

Navigators

Mary Sue Bouslog, RN
Small and Large Bowel Procedures

Cindy Doyle, ARNP
Neurosurgery/Back and Neck Procedures

Lynn Dee Sheridan, LISW
Trauma/Burn Unit

Jean Teale, LISW
Total Joint Replacement

Surgeon Advisors

Jody Buckwalter, MD
John Callaghan, MD
Charles Clark, MD
Joseph Cullen, MD
Matt Howard, MD
Pat Kealey, MD
John Marsh, MD
Todd McKinley, MD
Timothy Ryken, MD
Carol Scott-Conner, MD