The document outlines the key components of establishing an advanced practice nurse (APN) managed clinic. It discusses the professional requirements including education, knowledge, and qualified workforce. It also addresses the foundational elements needed such as mission, leadership, fiscal support, standards, marketing, and ensuring APNs are adequately prepared. Finally, it discusses methods of implementation including entrepreneurial, collaborative, and corporate models and the importance of understanding healthcare trends, meeting consumer needs, following research, overseeing finances, and monitoring policy changes to support establishing APN managed clinics.

1. The Advanced PracticeThe Advanced Practice
Nurse Managed Clinic:Nurse Managed Clinic:
Nurses Responding to ChangeNurses Responding to Change
nursingnursing@yahoo.in

2. Nurses Responding to ChangeNurses Responding to Change
 Identify the professional requirements forIdentify the professional requirements for
operating an APN managed clinicoperating an APN managed clinic
 List the social, cultural and legal implicationsList the social, cultural and legal implications
of establishing an APNMCof establishing an APNMC
 Discuss the potential of this method ofDiscuss the potential of this method of
providing health care within the nation’sproviding health care within the nation’s
current health care systemcurrent health care system

3. Foundational elements of a APNFoundational elements of a APN
Managed clinicManaged clinic::
Mission/Purpose/PhilosophyMission/Purpose/Philosophy
Leadership and ManagementLeadership and Management
Fiscal supportFiscal support
Professional standards and/or regulationsProfessional standards and/or regulations
Professionals prepared as APNsProfessionals prepared as APNs
Consumer/patient marketingConsumer/patient marketing

4. Mission-Mission-
Purpose-Purpose-
Philosophy-Philosophy-

5. LeadershipLeadership
ManagementManagement

6. Fiscal SupportFiscal Support

7. ProfessionalProfessional
StandardsStandards
RegulationsRegulations

8. APN PreparationAPN Preparation

9. Consumer/PatientConsumer/Patient
MarketingMarketing

10.  History of nurses managing health careHistory of nurses managing health care
independently and interdependentlyindependently and interdependently::
In home during child birth and plaguesIn home during child birth and plagues
In wars caring for the soldiersIn wars caring for the soldiers
In public/community health duringIn public/community health during
epidemicsepidemics

11. Professional RequirementsProfessional Requirements
EducationEducation
Knowledge workerKnowledge worker
Qualified workforceQualified workforce

12.  EducationEducation
Moved from hospitals to universitiesMoved from hospitals to universities
--beyond post-basic--beyond post-basic
Scientific advances created knowledgeScientific advances created knowledge
gapsgaps
Expanded role requires life longExpanded role requires life long
learninglearning

13.  Nurses became “knowledgeNurses became “knowledge
workers”*workers”*
Harnessing the power of theoretical andHarnessing the power of theoretical and
analytical knowledgeanalytical knowledge
Technology enhanced business andTechnology enhanced business and
networkingnetworking
Health care consumer is poorly servedHealth care consumer is poorly served
Workforce is redesignedWorkforce is redesigned
*White, K. & Begun, J. 1998, Nursing entrepreneurship in an era of chaos and complexity, Nrs.*White, K. & Begun, J. 1998, Nursing entrepreneurship in an era of chaos and complexity, Nrs.
Admin. Q. 22, (2); 40-47.Admin. Q. 22, (2); 40-47.

14. Qualified workforceQualified workforce
Qualified students for enrollmentQualified students for enrollment
Qualified faculty and approved curriculumQualified faculty and approved curriculum
Health care system open for APNsHealth care system open for APNs
APN role legitimizedAPN role legitimized
Fiscal support for educationFiscal support for education
Patient acceptance of APN rolePatient acceptance of APN role

15. Social, Cultural & LegalSocial, Cultural & Legal
ContextsContexts
 Social implicationsSocial implications
Women’s role in societyWomen’s role in society
Trends of health in nationTrends of health in nation
Direction of health policyDirection of health policy

16. Cultural influencesCultural influences
Perceived role of nursePerceived role of nurse
Employee versus independent providerEmployee versus independent provider
Risk taking and assertivenessRisk taking and assertiveness

17. Legal contextLegal context
Legitimate role and CredibilityLegitimate role and Credibility
Scope of practice and titleScope of practice and title
Professional and/or RegulatoryProfessional and/or Regulatory
competencecompetence

18. ““If you have the foresight,If you have the foresight,
you’re blessed, but if youyou’re blessed, but if you
have insight, you’re ahave insight, you’re a
thousand times blessedthousand times blessed.”.”

19. Foundational elements of a APNFoundational elements of a APN
Managed clinicManaged clinic::
Mission/Purpose/PhilosophyMission/Purpose/Philosophy
Leadership and ManagementLeadership and Management
Fiscal supportFiscal support
Professional standards and/or regulationsProfessional standards and/or regulations
Professionals prepared as APNsProfessionals prepared as APNs
Consumer/patient marketingConsumer/patient marketing

20. Methods for implementing APNMethods for implementing APN
Managed ClinicsManaged Clinics
Business approaches:Business approaches:
Entrepreneur or IntrapreneursEntrepreneur or Intrapreneurs
Collaborative practiceCollaborative practice
CorporationsCorporations

21. Entrepreneur or IntrapreneursEntrepreneur or Intrapreneurs
Starting a business focused onStarting a business focused on
health care, alone or with a partnerhealth care, alone or with a partner
Starting a business within anStarting a business within an
existing health care facility such as aexisting health care facility such as a
hospitalhospital

22. Collaborative practiceCollaborative practice
Working alongside or in partnershipWorking alongside or in partnership
with another professional in thewith another professional in the
business of health carebusiness of health care

23. CorporationsCorporations
Independently contract toIndependently contract to
establish a health service withinestablish a health service within
and existing non-health relatedand existing non-health related
corporationcorporation

24.  Infrastructure for Implementation of N-MC.Infrastructure for Implementation of N-MC.
Know the trends influencing health careKnow the trends influencing health care
Identify consumer’s unmet health needsIdentify consumer’s unmet health needs
Follow the scientific advancesFollow the scientific advances
Oversight of fiscal viabilityOversight of fiscal viability
Monitor health policy changesMonitor health policy changes

25. Infrastructure for implementationInfrastructure for implementation
Know the trends influencing healthKnow the trends influencing health
carecare
Demographic shift of populationDemographic shift of population
Burden of illness shiftBurden of illness shift
Provider ratio disparitiesProvider ratio disparities
PandemicsPandemics

26. Infrastructure for implementationInfrastructure for implementation
Consumer’s unmet health needsConsumer’s unmet health needs
Individual patientIndividual patient
High Risk populationsHigh Risk populations
Target groupsTarget groups
CommunityCommunity

27. Infrastructure for implementationInfrastructure for implementation
Scientific DiscoveriesScientific Discoveries
New procedures and medicationsNew procedures and medications
Current researchCurrent research
Opportunities for focal providersOpportunities for focal providers
Caseload managementCaseload management

28. Infrastructure for implementationInfrastructure for implementation
Fiscal viabilityFiscal viability
Securing and assuring funds forSecuring and assuring funds for
operation and advancement of clinicsoperation and advancement of clinics
Research the outcomes of health careResearch the outcomes of health care
Cost-effectiveness of APNsCost-effectiveness of APNs
Budget and accountingBudget and accounting

29. Infrastructure for implementationInfrastructure for implementation
Monitor health policy changesMonitor health policy changes
Involvement in policy processInvolvement in policy process
Monitor trends in governmentalMonitor trends in governmental
resource allocationresource allocation
Policy implications for nursing practicePolicy implications for nursing practice
Policy changes that affect patient carePolicy changes that affect patient care

30. APN Managed ClinicsAPN Managed Clinics
 The future of APN Managed ClinicsThe future of APN Managed Clinics
depends on all these factors and thedepends on all these factors and the
individual commitment to bring aboutindividual commitment to bring about
change. Barriers exist, but they can bechange. Barriers exist, but they can be
overcome through leadership, knowledgeovercome through leadership, knowledge
and collaboration. Success relates to theand collaboration. Success relates to the
efforts and energies of all nurses in yourefforts and energies of all nurses in your
community/nation working together tocommunity/nation working together to
make changemake change..

31. APN Managed ClinicsAPN Managed Clinics
Thank youThank you
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