Bridging Healthcare and Community Systems Through Forensic Navigation - Women and girls who experience sexual assault and other forms of violence often face significant barriers to recovery after a medical forensic examination. In addition to healthcare, many survivors require assistance accessing behavioral health services, victim advocacy, housing, legal resources, transportation, childcare, and other supports that promote safety and long term wellbeing. Geographic barriers, fragmented referral systems, workforce limitations, and challenges navigating complex service systems can prevent survivors from accessing these resources and remaining engaged in care. The University of Colorado Hospital Forensic Nurse Examiner (FNE) Program proposes to advance an established forensic navigator program serving patients affected by violence, abuse, exploitation, and victimization across Colorado. Since 2017, the FNE Program has provided 24-hour medical forensic services and has cared for more than 17,000 patients. Located primarily in a Level 1 trauma, quaternary referral, and academic teaching hospital, the FNE program sees survivors coming from across Colorado impacted by any form of violence or abuse. In Fall 2024, the program launched a nurse navigator model that has already provided enhanced support services to more than 2,750 patients, leading to measurable improvements in patient access to resources, follow-up, and coordination of care. Over the 24-month project period, nurse navigators will continue to provide individualized needs assessment, safety planning, follow up outreach, care coordination, and resource navigation for patients receiving services through the FNE Program. This award will further allow navigators to be integrated into community clinics and Family Justice Centers and provide them with ready access to much-needed additional patient resources. In doing so, this project will directly improve survivor access not only to forensic care services, but also other physical and mental healthcare, victim advocacy, housing assistance, legal support, transportation, emergency lodging, and other community resources. The project will place particular emphasis on improving continuity of care and reducing barriers that prevent women and girl survivors from accessing services. To do this, the project will also conduct continuous quality improvement and evaluation activities to strengthen multidisciplinary partnerships among healthcare providers, Family Justice Centers, victim service organizations, behavioral health providers, housing agencies, legal service organizations, and other community partners throughout Colorado. These engagement and evaluation activities will help identify key service gaps and improve responsiveness to survivors' needs, particularly in communication, access to resources, and coordination across healthcare and community systems. Findings will inform quality improvement efforts, strengthen care coordination, and support the development of sustainable strategies to advance navigator care. Expected outcomes of the project overall include improved access to forensic care and services, improved continuity of care between the FNE program and community partners, enhanced programmatic understanding of healthcare delivery gaps, and improved multidisciplinary responsiveness of healthcare and community systems serving women and girl survivors of violence. By bridging healthcare and community systems through this innovative forensic navigator model, the project will create a more coordinated, accessible, and survivor centered model of care that supports safety, healing, and recovery across Colorado.
