scholarly journals From New Nurse Practitioner to Primary Care Provider: Bridging the Transition through FQHC-Based Residency Training

2011 ◽  
Vol 17 (1) ◽  
Author(s):  
Margaret Flinter
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Health Center ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Residency Program ◽  
Primary Care Providers ◽  
Safety Net ◽  
Health Centers ◽  
Residency Programs

Community Health Center, Inc. (CHCI), a multi-site, federally qualified, health center (FQHC) in Connecticut, implemented a one-year-residency program for new nurse practitioners (NPs) in 2007. This residency program is specifically designed for family nurse practitioners intending to practice as primary care providers in federally qualified health centers. These centers comprise the nation's largest safety net setting; they are commonly referred to as community health centers. Supported in part by the Health Resources Service Administration, health centers are private nonprofit or public organizations serving populations with limited access to healthcare. They are located in designated, high need communities; governed by patient-majority boards of directors; and provide comprehensive, primary healthcare services. The author begins by reviewing the background and context for a nurse practitioner residency program, the importance of NP residency programs, and the recruitment and selection of NP residents. She explains how the residents are trained to a model of care and the content of care. She furthers the discussion by addressing program evaluation and outcomes and costs. Implications for national health policy, clinical practice, and nursing and areas for further research are presented. This article is timely in light of recent recommendations in the Institute of Medicine's 2010 report on the future of nursing recommending the development of residency programs for new, advanced practice registered nurses.

scholarly journals Deployment of Analytics into the Healthcare Safety Net: Lessons Learned

2016 ◽  
Vol 8 (3) ◽  
Author(s):  
David Hartzband ◽  
Feygele Jacobs
Keyword(s):  
Data Quality ◽  
Community Health ◽  
Health Center ◽  
Community Health Centers ◽  
Health Resources ◽  
Population Level ◽  
Safety Net ◽  
Lessons Learned ◽  
Health Centers ◽  
Effective Manner

To better understand existing capacity and help organizations plan for the strategic and expanded uses of data, a project was initiated that deployed contemporary, Hadoop-based, analytic technology into several multi-site community health centers (CHCs) and a primary care association (PCA). An initial data quality exercise was carried out after deployment, in which a number of analytic queries were executed using both the existing electronic health record (EHR) applications and in parallel, the analytic stack. Each organization carried out the EHR analysis using the definitions typically applied for routine reporting. The analysis using the analytic stack was carried out using those common definitions established for the Uniform Data System (UDS) by the Health Resources and Service Administration.  In addition, interviews with health center leadership and staff were completed to understand the context for the findings.The analysis uncovered many challenges and inconsistencies with respect to the definition of core terms (patient, encounter, etc.), data formatting, and missing, incorrect and unavailable data. At a population level, apparent underreporting of a number of diagnoses, specifically obesity and heart disease, was also evident in the results of the data quality exercise, for both the EHR-derived and stack analytic results.Data awareness, that is, an appreciation of the importance of data integrity, data hygiene and the potential uses of data, needs to be prioritized and developed by health centers and other healthcare organizations if analytics are to be used in an effective manner to support strategic objectives. While this analysis was conducted exclusively with community health center organizations, its conclusions and recommendations may be more broadly applicable. 

scholarly journals Excess Clinical Comorbidity Among HIV-Infected Patients Accessing Primary Care in US Community Health Centers

2017 ◽  
Vol 133 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Kenneth H. Mayer ◽  
Stephanie Loo ◽  
Phillip M. Crawford ◽  
Heidi M. Crane ◽  
Michael Leo ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Community Health ◽  
Community Health Centers ◽  
Primary Care Providers ◽  
Health Centers ◽  
Research Network ◽  
People Living With Hiv ◽  
Care Providers

Objectives: As the life expectancy of people infected with human immunodeficiency virus (HIV) infection has increased, the spectrum of illness has evolved. We evaluated whether people living with HIV accessing primary care in US community health centers had higher morbidity compared with HIV-uninfected patients receiving care at the same sites. Methods: We compared data from electronic health records for 12 837 HIV-infected and 227 012 HIV-uninfected patients to evaluate the relative prevalence of diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, and malignancies by HIV serostatus. We used multivariable logistic regression to evaluate differences. Participants were patients aged ≥18 who were followed for ≥3 years (from January 2006 to December 2016) in 1 of 17 community health centers belonging to the Community Health Applied Research Network. Results: Nearly two-thirds of HIV-infected and HIV-uninfected patients lived in poverty. Compared with HIV-uninfected patients, HIV-infected patients were significantly more likely to be diagnosed and/or treated for diabetes (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.22-1.41), hypertension (OR = 1.38; 95% CI, 1.31-1.46), dyslipidemia (OR = 2.30; 95% CI, 2.17-2.43), chronic kidney disease (OR = 4.75; 95% CI, 4.23-5.34), lymphomas (OR = 4.02; 95% CI, 2.86-5.67), cancers related to human papillomavirus (OR = 5.05; 95% CI, 3.77-6.78), or other cancers (OR = 1.25; 95% CI, 1.10-1.42). The prevalence of stroke was higher among HIV-infected patients (OR = 1.32; 95% CI, 1.06-1.63) than among HIV-uninfected patients, but the prevalence of myocardial infarction or coronary artery disease did not differ between the 2 groups. Conclusions: As HIV-infected patients live longer, the increasing burden of noncommunicable diseases may complicate their clinical management, requiring primary care providers to be trained in chronic disease management for this population.

scholarly journals Barriers to weight loss among community health center patients: qualitative insights from primary care providers

BMC Obesity ◽  
2016 ◽  
Vol 3 (1) ◽  
Author(s):  
Rebecca C. Woodruff ◽  
Gillian L. Schauer ◽  
Ann R. Addison ◽  
Ajay Gehlot ◽  
Michelle C. Kegler
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Community Health ◽  
Health Center ◽  
Community Health Center ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals Targeting the nurse practitioner workforce: Influences and barriers in choosing rural practice

2021 ◽  
Vol 12 (4) ◽  
pp. 51
Author(s):  
Mykell Barnacle ◽  
Allison Peltier ◽  
Heidi Saarinen ◽  
Christine Olson ◽  
Dean Gross
Keyword(s):  
Primary Care ◽  
Nurse Practitioners ◽  
Nurse Practitioner ◽  
Primary Care Providers ◽  
Rural Practice ◽  
Care Providers ◽  
Family Nurse Practitioner ◽  
Factors Influencing ◽  
Practice Readiness ◽  
The Impact

Background and objective: Recruitment and retention of primary care providers are projected to worsen in rural regions. Nurse practitioners (NPs) are a crucial solution to the shortage of primary care providers in rural America. Little research exists regarding factors influencing new NPs’ decisions to practice in rural settings, as well as practice readiness. The purpose of this study is to explore factors influencing new NPs’ decision to practice in rural settings.Methods: A survey of family nurse practitioner (FNP) graduates in a rural state was conducted. The survey measured rural background, current practice environment, the impact of rural clinical experiences on readiness to practice, and perceptions of rural NP practice.Results: The data collected over five years (N = 42) indicated several factors that influenced an NP’s decision to choose a position in a rural or underserved setting. A wide scope of practice, rural roots, a desirable job offer, and strong relationships were influential when choosing rural practice.Conclusions: Most respondents (69%) were not practicing in rural or underserved areas. Among those who were, the ability to practice to the full scope of education and autonomy were the most important factors. However, respondents were also apprehensive and intimidated with the broad skill set required in rural care. Implications: This study provides insight into factors and barriers for new graduate NPs in choosing a rural practice setting as well as possible solutions to the rural workforce shortage.

scholarly journals Integration of Hepatitis C Treatment in a Primary care Federally Qualified Health Center; Philadelphia, Pennsylvania, 2015-2017

2019 ◽  
Vol 12 ◽  
pp. 117863371984138 ◽  
Author(s):  
Tyler S Bartholomew ◽  
Kaitlin Grosgebauer ◽  
Katherine Huynh ◽  
Travis Cos
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Hepatitis C ◽  
Community Health ◽  
Health Center ◽  
Treatment Program ◽  
Community Health Centers ◽  
Health Centers ◽  
Hcv Treatment ◽  
Federally Qualified Health Center

Hepatitis C virus (HCV) infection remains a pressing public health issue. Identification of long term infection in primary care settings and community health centers can facilitate patients’ access to appropriate care. Given the increase in HCV prevalence in the United States, improving the HCV care continuum and expanding medication access to disproportionately affected populations can help reduce disease burden, health care system costs, and transmission. Innovative treatment programs developed in the primary care setting are needed to deliver quality care to meet the demand of those engaging in treatment. This article describes an HCV treatment program developed within a primary care federally qualified health center (FQHC) using physician assistants (PAs) and nurse practitioners (NPs) to address the high number of HCV positive patients identified at the clinic. An interdisciplinary care team was established to optimize patient experience around HCV care and treatment, using on-site primary care behavioral health consultants, an HCV treatment coordinator, and a 340B contracted specialty pharmacy. From January 2015 to April 2017, the Public Health Management Corporation (PHMC) Care Clinic medical providers referred 189 patients for HCV treatment. Of those referred, 102 patients successfully obtained a sustained virologic response (SVR), representing a 53.7% success rate from referral to cure. This treatment program successfully integrated HCV treatment in a patient population heavily affected by substance use and mental illness. Support and adoption of similar programs in primary care community health centers testing for HCV can help meet the clinical/behavioral needs of these marginalized populations.

scholarly journals Federally Qualified Health Centers Minimize the Impact of Loss of Frequency and Independence of Movement in Older Adult Patients through Access to Transportation Services

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Krystal Elaine Knight
Keyword(s):  
Primary Care ◽  
Community Health ◽  
Health Center ◽  
Older Adult ◽  
Case Reports ◽  
Community Health Center ◽  
Primary Care Providers ◽  
Adult Patients ◽  
Care Providers ◽  
The Impact

Loss of mobility in older adults (65 and older) is associated with falling, loss of independence, and mortality. This paper, which to the author's knowledge is the first of its kind, summarizes findings of Federally Qualified Health Center (FQHC) case reports and how FQHCs minimize the impacts of mobility loss in older adult patients (who would not receive primary services without these transportation programs) by providing access to primary care services through transportation programs. This paper features the transportation programs of four FQHCs located in both urban and rural United States areas: LifeLong Medical Care (Oakland, CA); Hudson Headwaters Health Network (Queensbury, NY); North End Community Health Center (Boston, MA); Aaron E. Henry Community Health Services Center, Inc. (Clarksdale, MS). This paper is beneficial to primary care providers and public health officials in outlining how transportation may be used to minimize the effects of mobility loss in older adult patients.

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