An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

Baker, Jeannemarie; Travers, Jasmine; Buschman, Penelope; Merrill, Jacqueline

doi:10.1177/1078390317704044

Cited by 20 publications

(9 citation statements)

References 39 publications

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“…PMH APRNs deliver a good deal of education in their practice, and it would be informative to understand the types of education provided, that is, if it was regarding medication, symptom management, and/or recovey. In the New York City clinic previously described, the educational component of the PMH NP role was signifant (Baker et al, 2018). Detailed reporting on these aspects of PMH NP practice should be a component of all reports on PMH APRN service models and would help fill the gap on knowldege of APRN role activitites and their impact.…”

Section: Discussionmentioning

confidence: 99%

“…Finally, additional sources that describe PMH APRN activities are the reports of practice models, often developed in an academic–practice partnership arrangement. In New York City a team of PMH NPs and their academic partner established a center for individuals who were homeless and dealing with serious mental illness (SMI; Baker, Travers, Buschman, & Merrill, 2018). The center was staffed exclusively by PMH NPs who provided both comprehensive mental health services and interventions to address social needs, such as housing.…”

Section: Literature Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey

Delaney

Drew

Rushton

2018

J Am Psychiatr Nurses Assoc

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Section: Discussionmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey

Delaney

Drew

Rushton

2018

J Am Psychiatr Nurses Assoc

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“…Second, many homeless clinics rely on volunteer medical providers as staff. The volunteer staff is not often able to provide stable long‐term provider–patient relationships, a prerequisite to a therapeutic medical relationship 22,27,37 . It has been demonstrated that dedicated family medicine physicians are well suited to manage the needs of homeless patients, providing continuity of care for patients and leadership for multidisciplinary teams 38 .…”

Section: Discussionmentioning

confidence: 99%

Dedicated homeless clinics reduce inappropriate emergency department utilization

Holmes

Macdonald

et al. 2020

JACEP Open

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Background The homeless patient population is known to have a high occurrence of inappropriate emergency department (ED) utilization. The study hospital initiated a dedicated homeless clinic targeting patients experiencing homelessness with a combination of special features. We aim to determine whether this mode of care can reduce inappropriate ED utilization among homeless patients. Methods We conducted a retrospective observational study from July 1, 2017 to Dec 31, 2017. The study enrolled all homeless patients who visited any hospital regular clinic, dedicated homeless clinic, and ED at least once during the study period. ED homeless patients were divided into four groups (A: no clinic visits; B: those who only visited hospital regular clinic; C: those who only visited dedicated homeless clinic; and D: those who visited both hospital regular clinic and dedicated homeless clinic). The New York University algorithm was used to determine appropriate ED utilization. We compared inappropriate ED utilization among patients from these groups. Multivariate logistic regression was used to determine the risks of different clinical visits in association with inappropriate ED utilization. Results A total of 16,323 clinic and 8511 ED visits occurred among 5022 unique homeless patients, in which 2450 unique patients were seen in hospital regular clinic, 784 patients in dedicated homeless clinic, 688 patients in both hospital regular clinic and dedicated homeless clinic, and 1110 patients with no clinic visits. Twenty‐nine percent (230/784) of patients from dedicated homeless clinic utilized the ED, among which 21% (175/844) of their ED visits were considered inappropriate. In contrast, 40% of patients from hospital regular clinic utilized the ED, among which 29% were inappropriate ( P < 0.001). The adjusted odds ratio (OR) was 0.61 (95% confidence interval [CI] = 0.50–0.74, P < 0.001) on dedicated homeless clinic predicting inappropriate ED visits in multivariate logistic regression. Conclusion Implementing a dedicated homeless clinic with these features can reduce ED inappropriate utilization among patients experiencing homelessness.

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“…The focus on population health will result in new models of care, such as the PMH APRN model developed in New York to address the needs of homeless individuals with serious mental illness (Baker, Travers, Buschman, & Merrill, 2018). It is unfortunate that this model could not be sustained due to billing and funding issues.…”

Section: Broader Influences On Workforce Developmentmentioning

confidence: 99%

The Psychiatric Mental Health Advanced Practice Registered Nurse Workforce: Charting the Future

Delaney

Vanderhoef

2019

J Am Psychiatr Nurses Assoc

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There is a well-documented demand for psychiatric providers, clinicians whose scope of practice includes all essential psychiatric services, such as assessment, diagnosis, psychotherapeutic/psychotherapy interventions, and psychotropic medication treatment (American Psychiatric Nurses Association, International Society of Psychiatric Mental Health Nurses, & American Nurses Association, 2014). Psychiatric mental health (PMH) Advanced Practice Registered Nurses (APRNs) have the education, training, and licensure to meet this demand. The PMH APRN workforce has been growing over the past 20 years and has the potential to mitigate the Mental Health Professional Shortage Areas (MHPSAs) that states are attempting to address (Delaney, 2017; Kaiser Family Foundation, 2016). However, federal reports and mental health workforce studies often mischaracterize the PMH APRNs' scope of practice and present conflicting data on the number of currently certified practitioners. The profession must meet the pervasive misinformation about PMH APRNs with a consistent, clearly articulated message about the scope of practice, range of skills, and types of services provided. To effectively participate in mental health workforce planning, the specialty must be armed with an accurate depiction of current PMH APRNs, data on the educational pipeline, the anticipated growth of the workforce, and expected retirements. Objective This article outlines the anticipated number and characteristics of the PMH APRN entrants to the workforce. Enrollment and graduation trends are examined to estimate 5-year growth of the workforce, taking potential retirements into consideration. We discuss facilitators and 806571J APXXX10.

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An Efficient Nurse Practitioner–Led Community-Based Service Model for Delivering Coordinated Care to Persons With Serious Mental Illness at Risk for Homelessness

Abstract: Mental health provisions in the recently passed 21st Century Cures Act support community mental health specialty treatment. The SPC provides a template for similar nurse practitioner-led models.

Cited by 20 publications

References 39 publications

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey

Report on the APNA National Psychiatric Mental Health Advanced Practice Registered Nurse Survey

Dedicated homeless clinics reduce inappropriate emergency department utilization

The Psychiatric Mental Health Advanced Practice Registered Nurse Workforce: Charting the Future

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