For APRNs, Innovation Trumps Barriers
"If brought to scale, the TCM could accelerate efforts within the U.S. to move from a fragmented health care system to an integrated, high-performing one," Mary D. Naylor, PhD, RN, FAAN, Marian S. Ware Professor in Gerontology and director, NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing, is quoted as saying in the brief.
Finally, the brief points to Duke University Health System's Department of Cardiovascular Medicine, which "leverages interprofessional teams to increase access to care and improve patient satisfaction." In other words, physicians and APRNs tag-team with patients, dividing duties between them.
Physicians develop care plans for new patients; NPs and PAs see returning or acutely ill patients; and RNs coordinate follow-up care, schedule procedures, and respond to triage calls. They also consult with each other as needed.
Such a model "requires a cultural shift," says Allison Dimsdale, DNP, RN, NP. But the effort to make the shift seems to be worth it: A pilot showed that patients like the model and that the average wait time for appointments dropped 57% for new patients and 75% for returning patients.
I found the examples in this brief heartening and exciting. Yes, there are things standing in the way of APRNs, but as these institutions show, a little innovation can go a long way in improving not only access to care, but also the care itself.
Alexandra Wilson Pecci is a managing editor for HealthLeaders Media.
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