From Early Screening to Ongoing Support — The Essential Role of EDSP Patient Navigators
When patients receive a positive test result for HIV, syphilis, or hepatitis C in the emergency department (ED), the next conversation they have can shape whether they understand their diagnosis, begin treatment, and stay connected to care. That conversation is often led by a Patient Navigator. A Patient Navigator provides outreach, patient education, coaching, linkage to care, documentation, data collection, and advocates for culture change in the hospital.
In 2018, the Bridge Center launched a model that transformed how hospital EDs respond to patients with substance use disorders by combining Medications for Addiction Treatment (MAT) with dedicated support from a substance use navigator.
Building on that patient-centered model, the Bridge Center partnered with the California Department of Public Health (CDPH) to build the Emergency Department Syphilis, HIV, and Hepatitis C Virus Screening Program (EDSP) from 2023-2026 to address the growing epidemic of sexually transmitted infections in California. Through a syndemic approach, EDSP supports equitable testing, treatment, and prevention through routine opt-out screening of syphilis, HIV, and HCV in the ED.
Though the model’s scope expanded beyond Bridge’s substance use disorder work, the foundation remained the same — pairing clinical care with compassionate patient navigation.
EDs are critical (and sometimes the first) access points for patients who might otherwise go without care. Receiving a new health result in a new place can feel isolating, but being guided to accurate information through nonjudgmental support can lead to sustained treatment. A 2023 study showed that over 50 percent of substance use patients who received navigation support were engaged in outpatient treatment within 30 days of ED discharge, compared to nearly 16 percent of patients who did not receive navigation support. EDSP Patient Navigators do far more than communicate test results. They provide health education in clear, understandable language, answer questions, connect patients to services, coordinate follow-up appointments, and help address barriers that might otherwise prevent someone from receiving ongoing care.
“EDSP Patient Navigators approach their role with compassion, clarity, respect, and empathy…” said LaToya Mitchell, Bridge Center Senior Navigator Project Manager, “helping patients understand their test results, treatment options, and prevention tips, and provide community resources to support patients’ needs outside of treatment.”
That compassionate approach is especially important when patients are receiving unexpected or life-changing news. During the EDSP webinar Patient Navigator Perspectives, EDSP Patient Navigator Phillip Castro reflected on that responsibility.
“We’re sometimes delivering life-changing diagnoses and so it’s important to … be there to support the patient with compassion, understanding, and really be that key linkage person to answer any questions that they may have about the disease stage,” Castro said.
As the 2023-2026 EDSP CDPH-funded cohort comes to a close, Bridge is celebrating the 28 participating sites and the incredible work they accomplished in their communities. One outcome stands out as a testament to the value of patient navigation: 57% of participating sites have permanently sustained their Patient Navigator positions after funding ended. Even more encouraging, 96% of EDs reported they will continue screening for HIV, syphilis, and HCV beyond the funding period.
These commitments reflect more than program sustainability — they demonstrate confidence in a model that works. These milestones are just the beginning. As additional data become available in the coming months, Bridge looks forward to sharing a more complete picture of the impact of the 2023–2026 EDSP CDPH-funded cohort on patients, EDs, and communities across California.