Quality Improvement Through an Innovative Nursing Health Care Model

Health care transformation has dramatically influenced the clinical settings for nursing students across the country, and as result innovative community clinical sites are being implemented.

Donna Meyer, MSN, RN
ANEF Chief Executive Officer, Organization for Associate Degree Nursing

No longer are students only having acute care clinical experiences, such as hospital-based rotations. There is an increasing shift to many unique community settings, such as day care settings, head start programs, YMCAs, public housing units, senior centers, soup kitchens, retirement homes and the list continues. One unique setting that has emerged is the nurse-managed center (NMC).

A center of efficiency

There are an estimated 250 nurse managed centers in the U.S., serving 1.5 million patients. The Institute of Medicine report also indicates that the use of nurse-managed centers is associated with 15 percent fewer ED visits, 35-40 percent fewer non-maternity hospital days and 25 percent less expenditures on prescriptions. Nurse-managed centers often provide these services to those least likely to receive them—low-income, medically underserved communities.

“NMCs allow for the expansion of primary care access and an impact on our health disparities.”

There is a growing body of research which supports the effectiveness and affordability of health care services provided by NMCs through nurse practitioners. Rural, medically underserved communities are challenged to provide quality health care services within their local geographic areas. Health care services are often several hours away, resulting in significant health disparities in rural communities.

Keeping nurses local

Potential local health care providers often leave rural areas for urban medical centers after receiving their clinical education outside their communities. To address this need to reach underserved individuals a unique model is the establishment of NMCs.

NMCs allow for the expansion of primary care access and an impact on our health disparities. Services generally offered by nurse practioners include, but not limited to are: diagnosis of illnesses, prescriptions for some medications, (follow-up care) chronic diseases such as asthma, high blood pressure, diabetes, women’s health, counseling and making referrals to physicians as needed.

Involving community colleges

While most implementations of nurse-managed centers have, until recently, centered on university-based nursing programs, a community college implementation offers an alternative model with several advantages. The underserved are often located throughout the state in widely distributed and sometimes remote locations beyond the reach of universities. Community colleges are embedded in the residents they serve and understand the specific health care needs of the communities they serve.

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