Post on 28-Dec-2015
transcript
Building Opportunities Building Opportunities for Your Nurse-Directed for Your Nurse-Directed
Health CenterHealth Center
Presented by Shari Shapleigh, BSN, RN, MS, FNP
Goals for the DayGoals for the Day
Understand the challenges that most nurse-directed health centers have in common
Discuss the sources of these challengesIdentify tactics to address these
challenges
Due to resources Day to day operations occupy all resources Difficult to make time to network and build
bridgesDue to location
Rural settings physically isolated Often fewer local providers and other health care
resources in area Physical isolation on campus
IsolationIsolation
• Population served:• uninsured or underinsured student
• 28.1% of students age 18-24 are uninsured• Minorities and older students even more likely to be uninsured• HSACCC survey found 36% of 25-29 year old community college
students were uninsured• Many more students are underinsured• Often not able to refer to outside providers• Pressure to perform more services in-house, stretching resources
further
IsolationIsolation
Manpower Often services begin with just one nurse provider Limited monies for staff, esp. if budget solely from
student health fees
Lack of Resources
Lack of Resources
Monetary◦rising health care costs◦budget cuts◦small student base
Lack of Lack of ResourcesResources
Lack of Lack of ResourcesResources
Challenges Challenges
IsolationIsolation
Lack of Resources
Lack of Resources
Compliance Issues
Compliance Issues
Immunization Compliance:
Another facet of resource shortages◦too time consuming for small staff◦health center doesn’t have budget to automate
No administrative support
Compliance Issues
Compliance Issues
IsolationIsolation
ChallengesChallengesCompliance
IssuesCompliance
Issues
Lack of Resources
Lack of Resources
ConflictConflict
Scope of Practice◦defined by State law◦advanced practice or nursing only?
Services Provided◦primary care or referral?◦dispensary or OTC?◦CLIA waived labs?
ConflictConflict
IsolationIsolation
ChallengesChallenges
Compliance Issues
Compliance Issues
Lack of Resources
Lack of Resources
ConflictConflict
Finding SolutionsFinding
Solutions
Support Networks: Professional
◦Regional College Health Association◦Nurse directors’ group◦Student Health Center listserv◦Local professional group
Finding SolutionsFinding
Solutions
The National Nursing Centers Consortium (NNCC) “….are health centers managed by nurses in partnership with the communities they serve. They provide direct access to nurses and high quality health services, which may include comprehensive primary health care, health promotion, education and health protection and disease prevention.”
Finding SolutionsFinding
Solutions
Support Network: Campus
StudentsAcademic Departments
Athletics
Admissions
Public Safety
Support Network: Local Entities
-Department of Health-Hospitals/Walk-in Clinics-Planned Parenthood-Nearby Colleges-Educational Resources
Finding SolutionsFinding
Solutions
IsolationIsolation
ChallengesChallenges
Compliance Issues
Compliance Issues
Lack of Resources
Lack of Resources
ConflictConflict
Finding SolutionsFinding
Solutions
Support NetworkSupport Network
Secure Extra
Resources
Secure Extra
Resources
Secure Extra Resources: HumanStudents
◦nursing◦business administration◦public health
Interns◦nurse practitioner◦nursing◦health education◦massage therapy
Finding SolutionsFinding
Solutions
Secure extra resources: Human
Contractual agreements with local providers
Finding SolutionsFinding
Solutions
Secure extra resources: Time
BenchmarkingAutomate
Finding Finding SolutionsSolutionsFinding Finding
SolutionsSolutions
IsolationIsolation
ChallengesChallenges
Compliance Issues
Compliance Issues
Lack of Resources
Lack of Resources
ConflictConflict
Finding SolutionsFinding
Solutions
Support NetworkSupport Network
Secure Extra Resources
Secure Extra Resources
HumanHuman
TimeTime
Strategize and
Advertise
Strategize and
Advertise
Promote your health center on campus – build its profile:
peer educators promotion work with Public Relations department on campus for
inclusion in campus newsletter/on Web site guest lecture in specific classes present to Board of Trustees
Finding SolutionsFinding
Solutions
Promote your health center on campus:Value points:
◦your services help the under-served◦more cost effective than traditional models◦nurses spend more time educating students
Finding SolutionsFinding
Solutions
IsolationIsolation
ChallengesChallenges
Compliance Issues
Compliance Issues
Lack of Resources
Lack of Resources
ConflictConflict
Finding SolutionsFinding
Solutions
Support NetworkSupport Network
Secure Extra Resources
Secure Extra Resources
HumanHuman
TimeTime
Strategize and
Advertise
Strategize and
Advertise
Create a Business
Case
Create a Business
Case
Create a Business CaseIdentify exactly what you wantGet an audience with decision makersSpeak their language and make a good
pitch! ◦include return on investment (ROI), profit margin,
quality assurance and operating costs in your analysis
◦ include figures from benchmarking to back up your argument
Finding SolutionsFinding
Solutions
College Director Clerical Physician NP/PA RN PopulationOnondagaCC 1 1 0 0 1 10,000*LaGuardiaCC 1 0 0 3FT/2PT 10,000Hudson ValleyCC+
1/1clinical coordinator
2 1 1FT/1PT 2 12,000
FingerlakesCC 1/1Immunization coordinator
1 1 5,100
BroomeCC+ 1(NP) 1 1(PT) 1 6,000CayugaCC 1(RN) 1,000SullivanCCC 1(RN) 1 1,400**MonroeCC 1 2 0 1(?) 5 17,500
IsolationIsolation
ChallengesChallenges
Compliance Issues
Compliance Issues
Lack of Resources
Lack of Resources
ConflictConflict
Finding SolutionsFinding
Solutions
Support NetworkSupport Network
Secure Extra
Resources
Secure Extra
Resources
HumanHuman
TimeTimeStrategize
and Advertise
Strategize and
Advertise
Create a Business
Case
Create a Business
Case
MoneyMoney
Where’s the money?
Grants Doing it all by yourself is difficult
◦find out about grants through networking◦research using Web sites such as grants.gov ◦partner with your grants research office within
your institution, if you have one, so they actually write the grant
Finding SolutionsFinding
Solutions
Where’s the money?
Refocus priorities so services aren’t so stretched
Investigate student health insurance options
Finding SolutionsFinding
Solutions
Challenges and Opportunities Challenges and Opportunities Need to BalanceNeed to Balance
IsolationIsolation
ChallengesChallenges
Compliance Issues
Compliance Issues
Lack of Resources
Lack of Resources
ConflictConflict
Finding SolutionsFinding
Solutions
Support NetworkSupport Network
Secure Extra
Resources
Secure Extra
Resources
HumanHumanTimeTime
Strategize and
Advertise
Strategize and
Advertise
Create a Business
Case
Create a Business
CaseMoneyMoney
ReferencesReferences
Atwater, Janet, Director of Health Services Hudson Valley Community College, Troy, NY. Personal interview, May 11, 2009.
Dalton, Brenda Director of Health Services and Women’s Health Nurse Practitioner, Spelman College Atlanta, GA. Personal interview, January 2009.
DeNavas-Walt, C.B. Proctor, and J. Smith. Income, Poverty, and Health Insurance Coverage in the United States: 2007. U.S. Census Bureau., August 2008.
Health Services Association California Community Colleges Survey, spring 2007. http://www.hsaccc.org/NCHASpring2007_Overview.pdf
Hurley, Janet. “The History and Practice of College Health.” University Press of Kentucky, 2002. pp 154-160.
Perry, Jayne, College Nurse Jeffersen Community College, Watertown, NY. Personal interview, March 2009.
Torrisi, D.L. and Hansen-Turton, T. “Community and Nurse Managed Health Centers: Getting Them Started and Keeping Them Going” National Nursing Centers Consortium Guide. Springer Publishing Company. New York, 2005.