Authors: Watts, Sharon A.; Gee, Julie¹; O'Day, Mary Ellen²; Schaub, Kimberley³; Lawrence, Renee⁴; Aron, David⁴; Kirsh, Susan

Source: Journal of the American Academy of Nurse Practitioners, Volume 21, Number 3, March 2009 , pp. 167-172(6)

Publisher: Wiley-Blackwell

Abstract:

Purpose:

To describe the roles of nurse practitioners (NPs) in a novel model of healthcare delivery for patients with chronic disease: shared medical appointments (SMAs)/group visits based on the chronic care model (CCM). To map the specific skills of NPs to the six elements of the CCM: self-management, decision support, delivery system design, clinical information systems, community resources, and organizational support. Data sources:

Case studies of three disease-specific multidisciplinary SMAs (diabetes, heart failure, and hypertension) in which NPs played a leadership role. Conclusions:

NPs have multiple roles in development, implementation, and sustainability of SMAs as quality improvement interventions. Although the specific skills of NPs map out all six elements of the CCM, in our context, they had the greatest role in self-management, decision support, and delivery system design. Implications for practice:

With the increasing numbers of patients with chronic illnesses, healthcare systems are increasingly challenged to provide necessary care and empower patients to participate in that care. NPs can play a key role in helping to meet these challenges.

Keywords: Chronic disease; nurse practitioners; models of care

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1745-7599.2008.00379.x

Affiliations: 1: Heart Failure Clinic, Department of Cardiology, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 2: Pharmacy Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 3: Department of Cardiology and Organ Transplant, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio 4: HSR&D Center for Quality Improvement Research, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, Ohio

Publication date: 2009-03-01

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