1. Utilizing Nurse Practitioners as Leaders within the Patient Centered Medical Home
Rebekah Compton DNP, RN, FNP-BC
Reagan Thompson DNP, RN, FNP-BC
University of Virginia Department of Family Medicine

2. Disclosures
The University of Virginia Department of Family Medicine

3. Objectives
Understand where Nurse Practitioners can function as leaders within a PCMH
Give examples of current NP leadership
Review opportunities to NP leadership
Review barriers to NP leadership

4. Improving Patient Care
Engaged and focused leadership can drive health care improvements and result in reduced patient harm
Needed shift in health care from volume to value
Leaders needed at all levels!
(Swenson, Pugh, McMullan, & Kabcenell, 2013)

5. UVA Family Medicine NPs in action
Examples of leadership roles
PCMH application process
Clinic leadership
Chronic disease management
Population Health
Discharge clinics

6. PCC Management Team Twice monthly meetings
A voice from each of our teams
Interaction with every area in clinic from access specialist to nursing to management
Improves communication

7. Population Health
Diabetes
Chronic disease management
Refugee care

8. Diabetes Group Visits There is not one standard model
Goal: to provide patients with all of the benefits of a traditional one-to-one appointment while creating a group dynamic to enhance patient care

9. Chronic Disease Management The Grand-Aides Program
Curriculum development & outcomes measurement
Education & Supervision of CNAs
Home visits & patient education
Focus on diabetes, hypertension, obesity

10. Refugee Clinic Leadership

11. Hospital Follow-up Clinic
Timely ED/hospital follow-ups
Improved access
Collaboration with inpatient team
Decreased readmission
Improved patient satisfaction
Improved compliance with care plan

12. NPs as Leaders Are there opportunities for NPs to lead?
72% of DNPs felt they had the opportunity for leadership, while 64% of the Master’s prepared NPs felt there were opportunities for leadership in which they may engage (p = .323).
Do NPs feel prepared to lead?
72% of the DNPs and 67% of the Master’s prepared NPs perceived support to engage in leadership (p = 0.63).

13. What Roles are NPs Interested In?
Clinical leadership roles (60%)
Clinical director, committee leadership, developing patient centered medical homes, creating practice protocols, develop patient empowerment programs
Quality improvement roles (49%)
Quality improvement based on evidence-based practice, steering committee member for quality improvement, leader in evaluation of patient outcomes
Leadership roles in education (32%)
Program development, provide nursing education, DNP educator, teaching and precepting NP and physician assistant students

14. NPs in scholarly leadership
Desire to participate in research (14%). Examples:
Performance improvement studies
Leading nursing research and patient outcomes/satisfaction studies
Develop evidence based research projects

15. Barriers to NP leadership
Lack or resources (38%)
Lack of time to engage in leadership (83% [n = 30] cited this issue)
Unequal opportunities (29%)

16. Conclusion NPs desire the opportunities to lead
NPs are prepared to lead
Work with NPs to develop new roles/share the load of improving patient care.
“The achievements of an organization are the results of the combined effort of each individual.”
~ Vince Lombardi

17. Questions?

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