Family Nursing and Healthcare

Nurse-managed clinics are a unique way to approach healthcare that uses skilled providers to provide services in areas that frequently lack healthcare providers. A failing university sponsored nurse managed clinic was completely restructured to better meet the needs of the population served in the Metro-East St. Louis area and to become fiscally sound. A two-pronged approach of in-house primary care and community outreach was taken utilizing advanced practice nurses. Challenges occurred with having the number of advanced practice nurses needed; insurance credentialing of all providers; insurance reimbursement of advance practice nurses as primary care providers; setting up electronic fund transfers for payments; obtaining an electronic health record system; changing the perspective of not only the public but of the university administration about nurse managed clinics; and most recently initiating an interprofessional approach to healthcare that incorporates social work, pharmacy, and dental. As a result of the efforts put into the changes by the clinic providers over the course of three years, the clinic has gone from being consistently in the red to consistently in the black. Programs, such as an asthma specialty clinic, continue to be added and the number of patients continues to grow.