Grand-Aides Make Nursing Go Further

Instead, they get instructions from a nurse supervisor who manages five to six Grand-Aides, he tells HealthLeaders Media. Grand-Aides collect data about patients to report back to their nurse supervisors. Then, the supervisor instructs the Grand-Aide in providing care instructions to the patients.

In a primary care setting, Grand-Aides will provide telephone triage for primary care conditions; they might give advice over the phone or make home visits, always under the instruction of the nurse supervisor. For transitional or chronic care, Grand-Aides go home from the hospital with chronic disease patients and help them with things like medication adherence and sticking with their treatment plan. They also use telemedicine tools so nurse supervisors can "see" the patients themselves, too.

The Grand-Aide "becomes a communicator and router" for relaying patient information to nurses, "getting it in a way that takes less time," Garson says.

And in a way that takes less money, too, according to a Health Affairs study published this month. The study examined pilot tests with Grand-Aides in two pediatric Medicaid settings, one of which was an urban federally qualified health center in Houston.

Researchers found that that the cost of the Grand-Aides program is $16.88 per encounter, compared to current Medicaid payments of $200 per clinic visit in Houston. Researchers estimated that Grand-Aides and their supervisors averted 62% of drop-in visits at the Houston clinic. None of the patients in the study visited the ED.