Introduction
Innovative nursing care delivery models are effective methods to improve the level of healthcare. A population group of interest in this paper is low income families living in the non-metropolitan area of Providence, RI. This region includes Foster, Burrillville, Glocester, and Scituate. These families have limited access to healthcare services. The most vulnerable representatives of this group are adolescents, who face a number of healthcare challenges. The specialty of the model is preventive care and chronic care. The medical setting will include two one-floor buildings where patients will be able to consult corresponding specialists. The goal of the Healthy clubs program is to address the main health issues of adolescents and coordinate families in the process of treatment of chronic states.
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Description of the Healthy Clubs Model
The development of any innovative health care model needs certain theoretical basis and the type of the mode depends on the problem, which is to be solved, and the potential that this strategy can offer for the future. The future of health care rests solidly with the strength nursing brings in holistic care, ability to collaborate and innovate from the bedside to the community and the ability to adapt to the changing environment. (Norlander, 2001, p.403). This idea of Norlander (2001) became a foundation of Healthy clubs. According to the stated above, this setting will consist of two buildings. One of them will provide services for adolescents, namely consultations and physical examinations. The adolescents living in poor families in the non-metro areas of RI have serious problems related to alcohol and marijuana consumption (Rhode Island Department of Health, 2012). 45% of high school students in Burrillville, 34% of students in Westerly & Tiverton, and 30% of students in Chariho report having abused alcohol in the past 30 days. In contrast, 21% of students statewide report current alcohol consumption. (Rhode Island Department of Health, 2012, p.6).
The second complex will serve as a mini clinic for adults and small children where they will be able to pass regular examinations of their breathing organs and to receive recommendations for preventing asthma development because In 2010, 15 percent of Rhode Island children had ever been diagnosed with the chronic respiratory disease, and 12 percent of the state’s children were currently living with asthma. (Centers for Disease, 2012, p.1). Women will be encouraged to participate in Women, Infants and Children (WIC) program due to the fact that the number of eligible females in not-metro regions is much lower than in the cities and suburbs (Rhode Island Department of Health, 2012). The discussed buildings will be painted mainly white and look plain and neat. It is possible to add some bright colors to the small clinic for adolescents. Some nursing associations, charity organizations and local government can financially support the project.
The offered model will be innovative for nursing care. The Healthy Clubs program fulfills all requirements determined for innovations in nursing and is coordinated with all stages of the broken cycle (Hughes, 2006). The scheme of Healthy clubs supports the statement that successful innovators imagine new ways old ideas can be used and that innovators put those concepts, which are promising, to the test. (Hughes, 2006, p. 95). Thus, some more or less old ideas of nurse-managed health settings and clinics focused on certain problematic areas of the region (community) are considered in the offered model.
Nurse led and nurse managed health care. A registered nurse will manage both facilities and hire other healthcare specialists. Each complex will have a receptionist. The clinic for adults will include a nurse practitioner and a registered nurse, and a building for adolescents will involve two nurse practitioners and a psychologist. The clinics will have to hire more specialists in consequence. The nurses were instrumental in developing the program because they offered the division of the healthcare setting and the number of specialists needed. The nurses are consulted in the issues of construction and budget. All other aspects are solved by them independently.
Partnerships and collaboration. The partnership and collaboration are crucial for the discussed model, though the access to health care services in non-metro areas of RI is highly limited, and it is impossible to develop a wide collaboration network (Rhode Island Department of Health, 2012). The partnership at the professional level will be established with seven hospitals, which exist in the non-metro area, and social workers who will be interested in the project.
Continuity of care across settings. Some of the discussed patients, especially those who have already developed asthma, may have to visit different settings because of the lack of specialists who will participate in the innovative care delivery program. In such a case, one of the nurses will regularly visit the patient in hospital and trace his or her progress. Moreover, this nurse will communicate with the patients family and prepare all necessary conditions for a patient to return home. The discussed innovative clinics do not presuppose that a patient will stay in them more than two days, but they are oriented at quick solutions of healthcare problems that were not addressed earlier.
Technology. Health clubs will adopt a mix of technology, particularly basic assessment tools, screening tests and some data processing systems that will collect and monitor the data concerning asthma cases.
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Development/Implementation Team for the Healthy Clubs Model
The discussed model pursues certain goals enumerated in the introductory part and can be successful only if implemented with a team of reliable specialists. The mentioned nurse practitioners, registered nurses and a psychologist are enough to commence implementing the strategy. However, in the course of its development, Healthy clubs also need additional specialists, namely a social worker (to prompt women to participate in the WIC), an occupational therapist (to assess the working conditions of the adults and to determine possible environmental hazards) and some licensed practical nurses who will exercise the authority to prescribe drugs. The communication and referrals can be handled in person and applying the single data base of asthma cases and most complicated cases in regards of teenagers. Unfortunately, the budget for implementing the innovative nursing program is limited and the setting could not afford hiring nurse assistants. All specialists involved will be effectively engaged.
Evaluation of Healthy Clubs: Outcome Measurement
After implementing the model, some possible outcomes for measurement will include patient and staff satisfaction and statistical data of decreased incidents of asthma in non-metro area. The data base will be prepared by social workers, statistical bureaus and the nurses working at the clinics, the information from whom will be gathered every two months. The partnering social workers will additionally work with the community to discover more about their needs and evaluate the level of access to healthcare services and whether they have a desire to experience the benefits of a new nursing model.
To conclude, it is essential to note, that innovative healthcare (nursing) delivery programs are a solution for improving the quality and access to medical services. The areas of non-metro RI and poor families living there are put of the focus of health administration of the state. However, local models like Healthy clubs possess a potential to improve the situation and offer medical and psychological assistance to the population groups who undoubtedly need it. The concept of Healthy clubs may be developed by various organizations and implemented in other regions of the state, depending on their requirements. The most significant obstacle in this perspective is the lack of financing but, hopefully, the local government will mobilize its support of the plan that may conduct benefits for the state and stimulate saving money on expensive treatment of the citizens.
