Group items tagged

This article speaks about the future of healthcare - specifically, how primary care is at the foundation of a robust health care system. The author argues that the key to improving the triple aim (health of populations, patient experience, cost of care) is to remove barriers to NP practice, allowing them to practice to their fullest capacity.

Recently published article in NEJM that pulls together some of the exciting things coming for NPs and RNs in continuing expanded roles to meet primary care needs in our health care system.

This article is about the scope of practice of midwives and childbirth outcomes. It discusses the relationship between autonomous practice and better birth outcomes. The article suggests there should be future policies to expand the access to midwifery services.

Article showing an application of teamwork in a primary care setting to develop a behavior health intervention. See the abstract below! J Am Board Fam Med. 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042. Abstract PURPOSE: This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. METHODS: This was a comparative case study in which a multidisciplinary team used an immersion-crystallization approach to analyze data from observations of practice operations, interviews with practice members, and implementation diaries. The observed practices were drawn from 2 studies: Advancing Care Together, a demonstration project of 11 practices located in Colorado; and the Integration Workforce Study, consisting of 8 practices located across the United States. RESULTS: Primary care and behavioral health clinicians used 3 interpersonal strategies to work together in integrated settings: consulting, coordinating, and collaborating (3Cs). Consulting occurred when clinicians sought advice, validated care plans, or corroborated perceptions of a patient's needs with another professional. Coordinating involved 2 professionals working in a parallel or in a back-and-forth fashion to achieve a common patient care goal, while delivering care separately. Collaborating involved 2 or more professionals interacting in real time to discuss a patient's presenting symptoms, describe their views on treatment, and jointly develop a care plan. Collaborative behavior emerged when a patient's care or situation was complex or novel. We identified contextual factors shaping use of the 3Cs, including: time to plan patient care, staffing, employing brief therapeutic approaches, proximity of clinical team members, and electronic health record documenting behavior. CONCLUSION: Primary care and behavioral health clinicians, through their interactions, c

Nurse Practitioner Workforce Article

This article addresses the importance of Nurse Practitioners in the work force. Currently, there is an ever growing healthcare worker shortage, especially in light of health reform coverage expansions in 2014. This article goes on to address the disparities found in state licensing and the scope of practice of Advanced Practice Registered Nurse.

This article discusses the effects of states' scope of practice laws and payment policies on the role of NPs in the primary care setting.

Great article by John Iglehart, Founding Editor, Health Affairs Population aging and recent coverage expansions have fueled concerns about physician shortages in primary care, leading several influential groups to recommend that nurse practitioners take on a larger role. The ACA promotes nurse practitioners as an integral part of the future workforce, and emerging care settings, such as retail clinics, rely heavily on nurse practitioners.

This observational study utilizes census data and geographic distribution of providers to illustrate current trends in distribution of providers, relative to uninsured patients and areas of limited access. Further, they discuss the policy changes aimed at bolstering access to primary care providers, specifically NP's, as a short term solution to a deficit in primary care providers. Additionally, the researchers explore distribution of APRNs, relative to scope of practice restrictiveness.

This article details the researchers' efforts to describe the ability of nurse practitioners to reduce health disparities. By reviewing the literature, the researchers were able to create a "Nurse Practitioner Health Disparities Model" that outlines the many factors that influence a NP's ability to reduce health disparities. Outside actors, such as policymakers and insurance companies, can also influence the ability of nurse practitioners to reduce health disparities. Thus, the model is a useful tool in promoting full practice for APRNs.