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The Advanced Practice The Advanced Practice Nurse Managed Clinic: Nurse Managed Clinic: Nurses Responding to ChangeNurses Responding to Change
Rosemary Goodyear Ed.D, APRN-BC, Rosemary Goodyear Ed.D, APRN-BC, FAANPFAANP
APN Managed Clinics:APN Managed Clinics: Nurses Responding to ChangeNurses Responding to Change
Identify the professional requirements Identify the professional requirements for operating an APN managed clinicfor operating an APN managed clinic
List the social, cultural and legal List the social, cultural and legal implications of establishing an APNMCimplications of establishing an APNMC
Discuss the potential of this method of Discuss the potential of this method of providing health care within the providing health care within the nation’s current health care systemnation’s current health care system
APN Managed ClinicsAPN Managed ClinicsFoundational elements of a APN Foundational elements of a APN
Managed clinicManaged clinic::Mission/Purpose/PhilosophyMission/Purpose/PhilosophyLeadership and ManagementLeadership and ManagementFiscal supportFiscal supportProfessional standards and/or Professional standards and/or
regulationsregulationsProfessionals prepared as APNsProfessionals prepared as APNsConsumer/patient marketingConsumer/patient marketing
APN Managed ClinicsAPN Managed Clinics
Mission-Mission-Purpose- Purpose- Philosophy-Philosophy-
APN Managed ClinicsAPN Managed Clinics
LeadershipLeadership
ManagementManagement
APN Managed ClinicsAPN Managed Clinics
Fiscal SupportFiscal Support
APN Managed ClinicsAPN Managed Clinics
Professional Professional StandardsStandards
RegulationsRegulations
APN Managed ClinicsAPN Managed Clinics
APN PreparationAPN Preparation
APN Managed ClinicsAPN Managed Clinics
Consumer/Patient Consumer/Patient MarketingMarketing
APN Managed Clinics APN Managed Clinics
History of nurses managing health care History of nurses managing health care independently and interdependentlyindependently and interdependently::
In home during child birth and plaguesIn home during child birth and plagues In wars caring for the soldiers In wars caring for the soldiers In public/community health during In public/community health during
epidemicsepidemics
APN Managed ClinicsAPN Managed Clinics
Professional RequirementsProfessional Requirements
EducationEducationKnowledge workerKnowledge workerQualified workforceQualified workforce
APN Managed ClinicsAPN Managed Clinics
EducationEducation
Moved from hospitals to universities --Moved from hospitals to universities --beyond post-basicbeyond post-basic
Scientific advances created knowledge Scientific advances created knowledge gapsgaps
Expanded role requires life long Expanded role requires life long learninglearning
APN Managed ClinicsAPN Managed Clinics
Nurses became “knowledge Nurses became “knowledge workers”*workers”*
Harnessing the power of theoretical and Harnessing the power of theoretical and analytical knowledgeanalytical knowledge
Technology enhanced business and Technology enhanced business and networkingnetworking
Health care consumer is poorly servedHealth care consumer is poorly servedWorkforce is redesignedWorkforce is redesigned
*White, K. & Begun, J. 1998, Nursing entrepreneurship in an era of *White, K. & Begun, J. 1998, Nursing entrepreneurship in an era of chaos and complexity, Nrs. Admin. Q. 22, (2); 40-47.chaos and complexity, Nrs. Admin. Q. 22, (2); 40-47.
APN Managed ClinicsAPN Managed Clinics
Qualified workforceQualified workforceQualified students for enrollmentQualified students for enrollmentQualified faculty and approved curriculumQualified faculty and approved curriculumHealth care system open for APNsHealth care system open for APNsAPN role legitimizedAPN role legitimizedFiscal support for education Fiscal support for education Patient acceptance of APN role Patient acceptance of APN role
APN Managed ClinicsAPN Managed Clinics
Social, Cultural & Legal Social, Cultural & Legal ContextsContexts Social implicationsSocial implications
Women’s role in societyWomen’s role in societyTrends of health in nationTrends of health in nationDirection of health policyDirection of health policy
APN Managed ClinicsAPN Managed Clinics
Cultural influencesCultural influences
Perceived role of nursePerceived role of nurseEmployee versus independent providerEmployee versus independent providerRisk taking and assertivenessRisk taking and assertiveness
APN Managed ClinicsAPN Managed Clinics
Legal context Legal context Legitimate role and CredibilityLegitimate role and Credibility
Scope of practice and titleScope of practice and titleProfessional and/or Regulatory Professional and/or Regulatory
competencecompetence
APN Managed ClinicsAPN Managed Clinics
““If you have the foresight, If you have the foresight, you’re blessed, but if you you’re blessed, but if you have insight, you’re a have insight, you’re a thousand times blessedthousand times blessed.”.”
APN Managed ClinicsAPN Managed ClinicsFoundational elements of a APN Foundational elements of a APN
Managed clinicManaged clinic::Mission/Purpose/PhilosophyMission/Purpose/PhilosophyLeadership and ManagementLeadership and ManagementFiscal supportFiscal supportProfessional standards and/or Professional standards and/or
regulationsregulationsProfessionals prepared as APNsProfessionals prepared as APNsConsumer/patient marketingConsumer/patient marketing
APN Managed ClinicsAPN Managed Clinics
Methods for implementing APN Methods for implementing APN Managed ClinicsManaged Clinics
Business approaches:Business approaches:Entrepreneur or IntrapreneursEntrepreneur or IntrapreneursCollaborative practiceCollaborative practiceCorporationsCorporations
APN Managed ClinicsAPN Managed Clinics
Entrepreneur or IntrapreneursEntrepreneur or Intrapreneurs
Starting a business focused on Starting a business focused on health care, alone or with a partnerhealth care, alone or with a partner
Starting a business within an existing Starting a business within an existing health care facility such as a hospitalhealth care facility such as a hospital
APN Managed ClinicsAPN Managed Clinics
Collaborative practiceCollaborative practice
Working alongside or in partnership Working alongside or in partnership with another professional in the with another professional in the business of health carebusiness of health care
APN Managed ClinicsAPN Managed Clinics
CorporationsCorporations
Independently contract to Independently contract to establish a health service within establish a health service within and existing non-health related and existing non-health related corporationcorporation
APN Managed ClinicsAPN Managed Clinics
Infrastructure for Implementation Infrastructure for Implementation of N-MC.of N-MC.Know the trends influencing health Know the trends influencing health
carecareIdentify consumer’s unmet health Identify consumer’s unmet health
needsneedsFollow the scientific advancesFollow the scientific advancesOversight of fiscal viabilityOversight of fiscal viabilityMonitor health policy changesMonitor health policy changes
APN Managed ClinicsAPN Managed Clinics
Infrastructure for implementationInfrastructure for implementation
Know the trends influencing health Know the trends influencing health carecareDemographic shift of populationDemographic shift of populationBurden of illness shiftBurden of illness shiftProvider ratio disparitiesProvider ratio disparitiesPandemicsPandemics
APN Managed ClinicsAPN Managed Clinics
Infrastructure for implementationInfrastructure for implementationConsumer’s unmet health needsConsumer’s unmet health needs
Individual patientIndividual patientHigh Risk populationsHigh Risk populationsTarget groupsTarget groupsCommunityCommunity
APN Managed ClinicsAPN Managed Clinics
Infrastructure for implementationInfrastructure for implementationScientific DiscoveriesScientific Discoveries
New procedures and medicationsNew procedures and medicationsCurrent researchCurrent researchOpportunities for focal providersOpportunities for focal providersCaseload managementCaseload management
APN Managed ClinicsAPN Managed Clinics
Infrastructure for implementationInfrastructure for implementationFiscal viabilityFiscal viability
Securing and assuring funds for Securing and assuring funds for operation and advancement of clinicsoperation and advancement of clinics
Research the outcomes of health care Research the outcomes of health care Cost-effectiveness of APNsCost-effectiveness of APNsBudget and accountingBudget and accounting
APN Managed ClinicsAPN Managed Clinics
Infrastructure for implementationInfrastructure for implementationMonitor health policy changesMonitor health policy changes
Involvement in policy process Involvement in policy process Monitor trends in governmental Monitor trends in governmental
resource allocationresource allocationPolicy implications for nursing practicePolicy implications for nursing practicePolicy changes that affect patient carePolicy changes that affect patient care
APN Managed ClinicsAPN Managed Clinics
The future of APN Managed Clinics The future of APN Managed Clinics depends on all these factors and the depends on all these factors and the individual commitment to bring about individual commitment to bring about change. Barriers exist, but they can be change. Barriers exist, but they can be overcome through leadership, overcome through leadership, knowledge and collaboration. Success knowledge and collaboration. Success relates to the efforts and energies of all relates to the efforts and energies of all nurses in your community/nation nurses in your community/nation working together to make change.working together to make change.
APN Managed ClinicsAPN Managed Clinics
Thank youThank you
Rosemary Goodyear Ed.D, APRN-BC, Rosemary Goodyear Ed.D, APRN-BC, FAANPFAANP
[email protected]@roadrunner.com