261832 Expanding a Nurse-Managed Primary Care Clinic in Appalachia: A Community-Academic Partnership

Monday, October 29, 2012 : 6:50 PM - 7:10 PM

Elizabeth Lloyd McGarvey, EdD , Department of Public Health Sciences, University of Virginia, Charlottesville, VA
Teresa Gardner, DNP, MSN, FNP-BC, FAANP , Free Clinic, The Health Wagon, Clintwood, VA
Paula Meade, DNP, MSN, BSN , Free Clinic, The Health Wagon, Clintwood, VA
Audrey Snyder, PhD, RN, ACNP-CS, FAANP, FAEN , School of Nursing, University of Virginia, Charlottesville, VA
Amy L. Taylor, MBA, CRA , Assistant Vice President for Research, Towson University, Towson, MD
Background: The Health Wagon, a free 5013c clinic, was awarded a HRSA Affordable Care Act in 2010 to form an academic partnership with the University of Virginia and other community agencies in Southwest Virginia (SWVA) Appalachia. The 4 counties targeted by the grant have almost 43% of residents below 200% of the federal poverty level, with 25% reporting no health insurance. Age-adjusted mortality rates in some of the counties are as much as 70% higher than the rate for the state of Virginia. Description: The primary goals of the grant are 1) to expand access to comprehensive health care with a public health focus on prevention, 2) to expand the number of clinical training opportunities for nurses, 3) to improve access to care and become a patient-centered family home for those without insurance or ability to pay, and 4) to improve clinical services and data collection ability by implementing an electronic medical record (EMR). Lessons Learned: Up-front training of all involved in the grant at start up is critical. Back up plans for scheduling nurses in training are important to accomodate unexpected, unavoidable events while ensuring training opportunities. Implementating an EMR into the daily operations of a busy free clinic takes more time and is more complex that EMR salespeople share! Recommendations: We report on progress to date related to each goal and share lessons learned related to public health practice and project implementation. Those planning such partnerships would benefit from contacting others who are working within a similar culture.

Learning Areas:
Administer health education strategies, interventions and programs
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice
Diversity and culture
Other professions or practice related to public health
Public health or related nursing

Learning Objectives:
1. Describe the relationships among a University School of Nursing, School of Medicine's Department of Public Health Sciences and a Free Clinic in Appalachia as they meet the goals and objectives of a HRSA -funded project to improve access to care in counties in the Appalachian mountains of Virginia. 2. Describe challenges and solutions to implementation, data collection and reporting.

Keywords: Access to Care, Community-Based Partnership

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a 20 year career in public health research & evaluation, and have been the PI, CO-PI or Chief Evaluator on numerous federally funded grants. I have expertise in community-academic public health partnerships concerning program evaluation and research. I lead the grant team and coauthored the grant on which this abstact is based. I have a strong publication history.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.