An Academic-Practice Partnership in a Medically Underserved Community

By Bond, Eleanor F. | Creative Nursing, October 1, 2014 | Go to article overview

An Academic-Practice Partnership in a Medically Underserved Community


Bond, Eleanor F., Creative Nursing


The University of Washington School of Nursing faculty partnered with leaders of a local community with the shared intention of improving health services for needy populations and preparing nursing students to collaborate with communities in caring for such populations. The resulting clinic has operated for more than a decade and has continually grown, now serving about 1,000 patients per month. More than 300 students have completed clinical or research activities at the clinic. Challenges have included provision of culturally informed, evidence-based care; integration of mental and primary health care services; chronic disease management; leveraging community partnerships in support of needy populations; and fiscal sustainability. A new project uses team-based approaches to implement interprofessional, relationship-centered care for families of newborns.

Keywords: collaborative care; integrated health services; academic-practice partnership; medically underserved

A creative, decade-long partnership between University of Washington School of Nursing (UWSON) and a local community has provided proof of concept for the role nurse practitioners (NPs) and registered nurses (RNs) can play-and a template for the role they will play-in delivering effective, efficient health care services to underserved populations while providing community-based clinical training for the next generation of nurses. This article describes the academic- practice collaboration that led to the design, implementation, and evaluation of an integrated health care clinic; discusses challenges that have emerged in the initial decade; and describes how the collaboration has benefited nursing students and faculty.

ACADEMIC-PRACTICE COLLABORATION

A partnership between UWSON and a local community was forged in 2002 in response to a local health care delivery crisis and emerging challenges in training nursing students. A nearby community had-and continues to have-a primary care provider shortage; the area has long been designated by the U.S. Department of Health & Human Services as a medically underserved area and a health professionals shortage area for primary care (Health Resources and Services Administration, 2014). At the time, uninsured and publicly insured patients had very limited access to primary care services. A 2002 study by the county public health department revealed that no private providers accepted new Medicaid patients, few accepted new Medicare patients, and the uninsured lacked access to services. Although there was a local community health clinic, it was underre- sourced: Patients were obliged to wait weeks for appointments. Chronic conditions and minor illnesses festered until they became major crises requiring emergency department visits, placing patients at avoidable risk for morbidity and mortality. The community medical center 's emergency department became one of the busi- est in the state, in large part because of the downward spiral in access to care for uninsured and publicly insured residents.

UWSON saw in this crisis an opportunity to serve the community while helping to create a unique urban venue in which nursing students could in- novate in providing care for disadvantaged, diverse, complex patients. Clini- cal placement of students, particularly NPs, was a growing challenge. School of Nursing values included collaboration, social responsibility, diversity, and ex- cellence; academic program objectives mandated preparing students to provide excellent care for diverse, marginalized, underserved, and vulnerable popula- tions. Innovative venues were required to explore creative, feasible solutions to real-world challenges.

Faculty members worked with community and medical center leaders to de- sign, implement, and evaluate a freestanding NP-managed clinic. The clinic opened in 2004, with the mission to provide excellent care for underserved populations by leveraging academic and community partnerships. …

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