Nurse-Led Health Clinics

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Nurse-Led Health Clinics

SKU# 9780826128027

Operations, Policy, and Opportunities


  • Tine Hansen-Turton MGA, JD, FCPP, FAAN
  • Susan Sherman RN, MA, FAAN, FCPP
  • Eunice S. King PhD, RN

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Delivers a wealth of information for nurses who wish to open and manage their own health clinics

Public health nursingówith its focus on compassionate, holistic care and services to the poor, the aged, those suffering from social injustice, and those without adequate health facilitiesóhad its origins over a century ago with the founding of the Henry Street Settlement in New York City. Embracing the same foundational principles, Nurse-Led Health Clinics is the first book to describe innovative, nurse-managed solutions for improving health care today. It addresses the key business, policy, medical, financial, and operational considerations necessary for successfully opening and operating nurse-led health facilities. With the mission to dramatically expand access to primary and preventive health care, these clinics provide a full range of servicesóincluding primary care, health promotion, disease prevention, and behavioral health careóto residents of underserved communities throughout the United States.

The book delivers a wealth of comprehensive information for nurses who are considering opening their own clinics. Reinforced with best-practice models and case studies, it discusses what it takes to successfully start and run a nurse-managed health center. The book addresses the history and growth of nurse-led clinics and describes the nurse-led paradigm of care. It identifies the different types of nurse-led clinics (primary care, school based, wellness, and more) and the clinical services offered within them. Also discussed are the requirements and mind-set of potential consumers and strategies for sustainability along with the role of the collaborative team. The pros and cons of a variety of business and operations models are examined along with quality metrics and initiatives. The book also covers various state and federal policy challenges and opportunities and explores the future of nurse-led care in view of ongoing health care reform. Helpful appendices include a start-up checklist, sample bylaws, and a managed-care contracting toolkit.


  • Describes key business, policy, medical, financial, and operational considerations for running a nurse-managed health center
  • Addresses the pros and cons of a variety of business models for nurse-led care
  • Identifies the most common clinical services offered
  • Presents quality metrics, best-practice models, and case studies
  • Includes state and federal policy and regulatory challenges and opportunities

Tine Hansen-Turton, MGA, JD, FCPP, FAAN, is a social entrepreneur who has started several national and global social and public innovations in the health and human services sector. For the past two decades she has been instrumental in leading a movement of nurse-led primary health care, positioning advanced practice nurses and nurse practitioners as primary health care providers. She is currently the chief strategy officer of Public Health Management Corporation (PHMC), where she oversees and leads corporate strategy, development, and operations for a public health institute. She serves as CEO of the National Nursing Centers Consortium, a nonprofit organization supporting the growth and development of over 500 nurse-led health centers, serving more than 2.5 million vulnerable people across the country. Additionally, she serves as the founding executive director for the Convenient Care Association, the U.S.-based trade association of the private-sector retail clinic industry. She is co-author of numerous publications including but not limited to Partnerships for Health and Human Service Nonprofits; Social Innovation and Impact in Nonprofit Leadership; Convenient Care Clinics: The Essential Guide for Clinicians, Managers, and Educators; Community and Nurse-Managed Health Centers: Getting Them Started and Keeping Them Going; and Nurse-Managed Wellness Centers: Developing and Maintaining Your Center. In 2009 she cofounded Philadelphia Social Innovations Journal (PSIJ), an online publication that brings a focus to social innovators and their nonprofit organizations, foundations, and social sector businesses. Following the creation of PSIJ, she cofounded the Philadelphia Social Innovations Lab to serve as a hub to test new social models which she now teaches as an adjunct professor at University of Pennsylvania, Fels Institute of Government.

Susan Sherman, MA, RN, has served as president and CEO of the Independence Foundation since 1996. The Independence Foundation, a private philanthropy dedicated to supporting programs in Philadelphia and surrounding Pennsylvania counties that provide services to people who ordinarily do not have access to them, has four specific areas of funding: culture and arts; health and human services; nurse-managed primary health care; and public interest legal aid. Ms. Sherman is a member of the board of directors of the Public Health Management Corporation (PHMC), Project H.O.M.E., and the Academy of Vocal Arts, and was chairperson of the Philadelphia Award Committee. She serves on the advisory committees of the American Academy of Nursing, Philadelphia Social Innovations Journal, the Metropolitan AIDS Neighborhood Nutrition Alliance, Students Run Philly Style, and Meds & Eds Alliance. She also serves on the Eisenhower Fellowships Philadelphia International Leadership Initiative Steering Committee, the Pennsylvania Action Coalition Steering Committee, and the Pennsylvania Bar Association Judicial Evaluation Commission. She is a fellow of the American Academy of Nursing and the College of Physicians of Philadelphia.

Eunice S. King, PhD, RN, is a senior program officer and director of research and evaluation for the Independence Foundation, where she has overseen the foundation's grant making under the nurse-managed health care initiative. In addition, she is the program evaluation consultant to the National League for Nursing's Advancing Care Excellence for Seniors (ACES) program, a partnership between the National League for Nursing and Community College of Philadelphia. Prior to joining the Independence Foundation, Dr. King was associate dean for research in the MCP Hahnemann School of Nursing at Drexel University, where she taught graduate courses in research and studied issues of medication adherence among individuals living with HIV and AIDS. Upon completion of her PhD studies, she joined the behavioral research staff of the Fox Chase Cancer Center Division of Population Science, where she conducted National Cancer Instituteñfunded studies that developed and tested strategies to promote mammography use among women, and a Pennsylvania Department of Healthñfunded study to encourage smoking cessation among pregnant women. Earlier in her career, Dr. King was a psychiatric nurse clinical specialist in a variety of health care settings, including an acute care psychiatric hospital, a community mental health clinic, and a general hospital. In addition, she held a faculty position at the Villanova University College of Nursing and was an independent psychiatric nursing consultant.

Product Details 

  • Publication Date March 16, 2015
  • Page Count 304
  • Product Form Paperback / softback
  • ISBN 13 9780826128027
  • EISBN 9780826128034

Table of Contents 



Foreword Loretta Ford, RN, PNP, EdD, FAAN, FAANP

Foreword Sandra Festa Ryan, MSN, RN, CPNP, FCPP, FAANP, FAAN


Introduction Susan B. Hassmiller, PhD, RN, FAAN


Tine Hansen-Turton

1. Anatomy of a Nurse-Led Clinic: An Introduction to the Model of Care

Tine Hansen-Turton, Brian Valdez, Jamie M. Ware, and Eunice S. King

Background: Origins of the NMHC Model of Care

The Role of the Division of Nursing in the Development of NMHCs

What Is an NMHC?

2. The Independence Foundation’s Contributions to the Nurse-Managed Health Center Movement

Eunice S. King

Background and History of Interest in Nursing

The History of IF-Funded Nurse-Managed Health Centers: 1993–2013

The NNCC: Laying the Groundwork for the Growth and Recognition of NMHCs


3. Building a Nurse-Managed Clinic

Donna L. Torrisi and Tine Hansen-Turton

How to Start a Nurse-Managed Health Center

Initial Planning

Financial Operations

Policies and Procedures

Continuous Quality/Performance Improvement

Information Systems

4. Nurse-Managed Health Centers and Sustainability

Bonita Ann Pilon and Tine Hansen-Turton

Strategies for Sustaining Nurse-Managed Clinics: A Balancing Act


5. The Role of the Collaborative Team in Nurse-Managed Health Centers

Nancy L. Rothman and Donald B. Parks

CRNPs: Leading Interdisciplinary/Interprofessional Collaborative Teams

Collaboration and Patient-Centered Medical Homes

6. Quality

Kathryn Fiandt and Nancy L. Rothman

Quality of Health Care in the United States

Quality Processes

The National Nursing Center NMHC Certification Initiative

A Case Study


7. Patient Satisfaction With Care Received in Nurse-Managed Primary Care Clinics: The Numbers and the Stories

Eunice S. King and Nancy L. Rothman

The Focus Group


8. Providing Behavioral Health Care Within Nurse-Managed Health Clinics: A Journey Toward Full Integration—The Abbottsford Falls Community Health Center

Donna L. Torrisi

1992: A Commitment to Behavioral Health From the Start

1994–2000: The Growth of Outpatient BH Services

2000–2009: The Depression Collaborative

2010: The BH Consultant Model




Geraldine Bednash

Nurse-Managed Centers—An Avenue for Change and Health

9. Joining Hands With a Vulnerable Community: The Family Practice and Counseling Network

Donna L. Torrisi and Jessie Torrisi

The Godmother (June 1991)

Reclaiming Piper’s Row (July 1992)

The Unsteady Steps of Expansion (1994 and 1995)

The Political Pitfalls of Change (March 1995)

A Lesson in Humility (January 1997)

Shootings and Sorrows (1997 and 1998)

Joys (May 1998)

Bringing Behavioral Health Into the Exam Room (2009)

Our First Rural Health Center (2012)

Twenty-Two Years Into the Journey (February 2014)

10. 11th Street Family Health Services of Drexel University: A University–Community Partnership

Patricia Gerrity


The Recipe

Differentiating Ingredients

Sampling the Cake: Data, Outcomes, and Model Effectiveness

The Recipe Evolves: The Development of a Health Campus


11. The Senior House Calls Program

M. Christina R. Esperat, Linda McMurry, and Sally Coates


Services Provided

Challenges and Issues

Client Responses

12. Convenient Care Clinics: Lessons Learned From Consumer-Driven Health Care

Sandra Festa Ryan and Sarah Rosenberg

Overview of the Industry

What Are CCCs?

The Role of Consumers in Validating the Industry



Tine Hansen-Turton

13. Overview of Nurse-Managed Wellness Centers and Wellness Programs Integrated Into Nurse-Managed Primary Care Clinics

Lenore K. Resick, Mary Ellen T. Miller, and Maureen E. Leonardo

Healthy People 2020

Organizational Frameworks


Wellness Centers and Integrated Wellness Programs in Traditional Primary Care Models: Filling the Health Care Gap

14. The 19130 Zip Code Project: A Journey to Our Neighborhood

Andrea Mengel and M. Elaine Tagliareni

Preparing Students for the 19130 Zip Code Project Clinical Experience

Providing Health Promotion and Disease Prevention Services in Our Community

Sustainability and Replicability


Frances Hughes

15. Workforce Trends and the Growth of the Advanced Practice Nurse Role

Sarah Hexem, Brian Valdez, and Jamie L. Ware

The NP in Primary Care: Looking Ahead

The NP Workforce by the Numbers

Federal Policies to Advance the Advanced Practice Nursing Workforce


16. The Future of Nurse-Managed Care and National Policy Efforts

Brian Valdez, Sarah Hexem, and Jamie M. Ware

The ACA and Its Relevance for NMHCs

The IOM’s The Future of Nursing Report and Its Impact on NMHCs

Future Directions


17. Health Care Transformations and The Future of Nursing: Campaign for Action

Susan B. Hassmiller

Appendix A: Nurse-Managed Health Clinic Start-Up Checklist

Appendix B: Sample Nurse-Managed Health Clinic Bylaws

Appendix C: The National Nursing Centers Consortium Managed Care Contracting Toolkit

Tine Hansen-Turton