The Advanced Practice Nurse Managed Clinic: Nurses Responding to Change

1. The Advanced Practice Nurse Managed Clinic: Nurses Responding to Change Rosemary Goodyear Ed.D, APRN-BC, FAANP

2. APN Managed Clinics:Nurses Responding to Change • Identify the professional requirements for operating an APN managed clinic • List the social, cultural and legal implications of establishing an APNMC • Discuss the potential of this method of providing health care within the nation’s current health care system

3. APN Managed Clinics • Foundational elements of a APN Managed clinic: • Mission/Purpose/Philosophy • Leadership and Management • Fiscal support • Professional standards and/or regulations • Professionals prepared as APNs • Consumer/patient marketing

4. APN Managed Clinics • Mission- • Purpose- • Philosophy-

5. APN Managed Clinics • Leadership • Management

6. APN Managed Clinics • Fiscal Support

7. APN Managed Clinics • Professional Standards • Regulations

8. APN Managed Clinics • APN Preparation

9. APN Managed Clinics • Consumer/Patient Marketing

10. APN Managed Clinics • History of nurses managing health care independently and interdependently: • In home during child birth and plagues • In wars caring for the soldiers • In public/community health during epidemics

11. APN Managed Clinics • Professional Requirements • Education • Knowledge worker • Qualified workforce

12. APN Managed Clinics • Education • Moved from hospitals to universities --beyond post-basic • Scientific advances created knowledge gaps • Expanded role requires life long learning

13. APN Managed Clinics • Nurses became “knowledge workers”* • Harnessing the power of theoretical and analytical knowledge • Technology enhanced business and networking • Health care consumer is poorly served • Workforce is redesigned *White, K. & Begun, J. 1998, Nursing entrepreneurship in an era of chaos and complexity, Nrs. Admin. Q. 22, (2); 40-47.

14. APN Managed Clinics • Qualified workforce • Qualified students for enrollment • Qualified faculty and approved curriculum • Health care system open for APNs • APN role legitimized • Fiscal support for education • Patient acceptance of APN role

15. APN Managed Clinics • Social, Cultural & Legal Contexts • Social implications • Women’s role in society • Trends of health in nation • Direction of health policy

16. APN Managed Clinics • Cultural influences • Perceived role of nurse • Employee versus independent provider • Risk taking and assertiveness

17. APN Managed Clinics • Legal context • Legitimate role and Credibility • Scope of practice and title • Professional and/or Regulatory competence

18. APN Managed Clinics • “If you have the foresight, you’re blessed, but if you have insight, you’re a thousand times blessed.”

19. APN Managed Clinics • Foundational elements of a APN Managed clinic: • Mission/Purpose/Philosophy • Leadership and Management • Fiscal support • Professional standards and/or regulations • Professionals prepared as APNs • Consumer/patient marketing

20. APN Managed Clinics • Methods for implementing APN Managed Clinics • Business approaches: • Entrepreneur or Intrapreneurs • Collaborative practice • Corporations

21. APN Managed Clinics • Entrepreneur or Intrapreneurs • Starting a business focused on health care, alone or with a partner • Starting a business within an existing health care facility such as a hospital

22. APN Managed Clinics • Collaborative practice • Working alongside or in partnership with another professional in the business of health care

23. APN Managed Clinics • Corporations • Independently contract to establish a health service within and existing non-health related corporation

24. APN Managed Clinics • Infrastructure for Implementation of N-MC. • Know the trends influencing health care • Identify consumer’s unmet health needs • Follow the scientific advances • Oversight of fiscal viability • Monitor health policy changes

25. APN Managed Clinics • Infrastructure for implementation • Know the trends influencing health care • Demographic shift of population • Burden of illness shift • Provider ratio disparities • Pandemics

26. APN Managed Clinics • Infrastructure for implementation • Consumer’s unmet health needs • Individual patient • High Risk populations • Target groups • Community

27. APN Managed Clinics • Infrastructure for implementation • Scientific Discoveries • New procedures and medications • Current research • Opportunities for focal providers • Caseload management

28. APN Managed Clinics • Infrastructure for implementation • Fiscal viability • Securing and assuring funds for operation and advancement of clinics • Research the outcomes of health care • Cost-effectiveness of APNs • Budget and accounting

29. APN Managed Clinics • Infrastructure for implementation • Monitor health policy changes • Involvement in policy process • Monitor trends in governmental resource allocation • Policy implications for nursing practice • Policy changes that affect patient care

30. APN Managed Clinics • The future of APN Managed Clinics depends on all these factors and the individual commitment to bring about change. Barriers exist, but they can be overcome through leadership, knowledge and collaboration. Success relates to the efforts and energies of all nurses in your community/nation working together to make change.

31. APN Managed Clinics • Thank you • Rosemary Goodyear Ed.D, APRN-BC, FAANP rtgoodyear@roadrunner.com