Collaboration between nursing and business faculty, clinical practice staff, and a graduate business student led to the formation of a business model for primary care (PC). This model demonstrates that optimizing practice in the interprofessional clinical learning environment has a direct positive impact on patient care.
Primary care practice challenges include fragmented and duplicated services and insufficient care coordination resulting in increased cost and decreased quality. Registered nurses practicing at their full scope of practice (FSP) can alleviate fragmented care, improve care quality, and contribute to the practices’ financial solvency. Many PC facilities ineffectively utilize RNs to their FSP and substitute Certified Medical Assistants (CMAs) or Licensed Practical Nurses (LPNs) for RNs (Bodenheimer & Mason, 2017).
The interprofessional team developed a sustainable PC practice model incorporating the full spectrum of RNs’ abilities. When RNs achieve FSP, RN provided services are billable and RNs’ value is recognized. Primary care opportunities are numerous including patient education, immunizations, diabetes management, and wound care. Registered nurse visits are divided into two types: independent visits and co-visits. Both types of RN visits can improve the efficiency and economics of the PC practice and lead to increased patient and provider satisfaction (Needleman, 2017).
To show financial sustainability utilizing RNs at FSP, a business model with economic implications was developed to integrate RNs into PC practice. This project demonstrated that a positive return on investment can be realized by implementing independent RN visits or co-visits. Using a hypothetical PC clinic, the model compared the costs of hiring RNs instead of LPNs and CMAs and proves that RNs contribute to a positive return on investment by practicing at FSP. The results increased patient volume leading to increased revenue for the clinic thus affecting patient satisfaction.
Funding: HRSA, NEPQR �" Registered Nurses in Primary Care. Grant: UK1HP31709
Disclosures:
In accordance with the Accreditation Council for Continuing Medical Education’s Standards for Commercial Support, adopted by the Joint Accreditors for Interprofessional Continuing Education, the National Center for Interprofessional Practice and Education has a conflict of interest policy that requires that all individuals involved in the development of activity content disclose their relevant financial relationships with commercial interests. All potential conflicts of interest that arise based upon these financial relationships are resolved prior to the educational activity.
Elizabeth Kalb, Kathy Riedford, Tracy Kinner, Constance Swenty, Marilyn Ostendorf, Ane Johannessen, Anders Baerheim, Catherine Demko, Ellen Luebbers
declare no vested interest in or affiliation with any commercial interest offering financial support for this interprofessional continuing education activity, or any affiliation with a commercial interest whose philosophy could potentially bias their presentation.
