Training the Next Generation

Training the Next Generation Residency and Fellowship Programs for Nurse Practitioners in Community Health Centers C O - A U T H O R S : Margaret Flinter, APRN, PhD, c-FNP, FAAN, FAANP and Kerry Bamrick, MBA E D I T O R : Kathleen Thies, PhD, RN and the Training the Next Generation Residency and Fellowship Programs for Nurse Practitioners in Community Health Centers C O - A U T H O R S : Margaret Flinter, APRN, PhD, c-FNP, FAAN, FAANP and Kerry Bamrick, MBA This monograph is in the public domain and may be reproduced or copied E D I T O R : without permission. Citation, however, is appreciated. Kathleen Thies, PhD, RN Training the Next Generation: Residency and Fellowship Programs for Nurse Practitioners in Community Health Centers Co-Authors: Margaret Flinter, APRN, PhD, c-FNP, FAAN, FAANP Kerry Bamrick, MBA Accessible for PDF download at: https://www.weitzmaninstitute.org/NPResidencyBook View and download appendices at: https://www.weitzmaninstitute.org/NPResidencyBook ABOUT THE AUTHORS Dr. Margaret Flinter is the Senior VP and Clinical Direc- Kerry Bamrick is the Program Director for the Com- tor of the Community Health Center, Inc. (CHCI), a state- munity Health Center, Inc. (CHCI) and its Weitzman In- wide federally qualified health center serving 150,000 stitute’s Postgraduate Residency Training Programs. patients from its primary care centers across Connecti- In this role, she oversees the management of all CHCI cut, while leading practice transformation initiatives Postgraduate Residency Training Programs. CHCI’s resi- across the country. A family nurse practitioner since dency programs include: the Nation’s First Family Nurse 1980, she has held progressive roles in the organization Practitioner Residency Training Program, Postdoctor- as both a primary care provider and executive leader as al Clinical Psychology Residency Program, Psychiatric CHCI transformed from a free clinic to one of the coun- Mental Health Nurse Practitioner Residency Program try’s largest and most innovative FQHCs. In 2005, she and Center for Key Populations Fellowship. Future plans founded CHCI’s Weitzman Center for Innovation, now include implementing a Dental Public Health Residency the Weitzman Institute, which is CHCI’s research, inno- Program. vation, and quality improvement arm. Margaret served as the national co-director of the Robert Wood Johnson Foundation’s Primary Care Kerry is also responsible for overseeing and managing all aspects of CHCI’s remote- Teams: Learning from Effective Ambulatory Practices (LEAP) project, which is study- ly-hosted nurse practitioner residency programs across the country. Currently, CHCI ing exemplar primary care practices across the country. Margaret has led the nation- is remotely hosting nurse practitioner residency programs in the states of California, al development of a model of post-graduate residency training programs for new Hawaii, Indiana, New York, Oregon, Rhode Island, and Washington. In addition to nurse practitioners and established the National Nurse Practitioner Residency and ensuring the successful operation of CHCI’s various residency training programs and Fellowship Training Consortium. Margaret is the Principal Investigator for HRSA’s Na- remotely hosted nurse practitioner residency programs, she also serves as CHCI’s tional Cooperative Agreement on Clinical Workforce Development. Since 2009, she Institutional Review Board (IRB) Administrator and Co-Principal Investigator for HR- has co-hosted, along with CHCI’s CEO Mark Masselli, a weekly radio show, “Conver- SA’s National Cooperative Agreement (NCA) on Clinical Workforce Development. sations on Health Care”, which connects people with issues of health policy, reform, and innovation, and speaks widely on topics related to primary care transformation. Kerry completed the Clinical Microsystems training at the Dartmouth Institute and is a certified coach. She is a CT AHEC Advisory Board Member and a member of the Margaret received her BSN from the University of Connecticut, her MSN from Yale Connecticut Institute for Clinical and Translational Science (CICATS) IRB Administra- University, and her PhD at the University of Connecticut. She is a fellow of the Amer- tors. Kerry has an undergraduate degree from Merrimack College and a Master’s ican Academy of Nursing and the American Academy of Nurse Practitioners, and Degree in Business Administration from Western New England College. served in the U.S. National Health Service Corps. —Kerry Bamrick, MBA —Margaret M. Flinter, APRN, PhD, FAAN, FAANP, c-FNP Director, Postgraduate Training Programs Senior Vice President and Clinical Director, Community Health Center, Inc. Community Health Center, Inc., Weitzman Institute Founder Emeritus, Weitzman Institute, Community Health Center, Inc. For more information please contact: [email protected]. HRSA Acknowledgement: CONTRIBUTING AUTHORS This project was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Charise Corsino, MA Human Services (HHS) under cooperative agreement number U30CS29049, Candice S. Rettie, PhD Training and Technical Assistance National Cooperative Agreement Kathleen Thies, PhD, RN for $1,000,000 with 6% of the total NCA project financed with non-federal sources. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any ACKNOWLEDGEMENT endorsements be inferred by HRSA, HHS or the U.S. Government. From the Co-Authors NCA Contributors: We want to acknowledge and thank the individuals who served as A project like this book would not be possible without the contributions of many expert faculty for the NCA, often developing new tools and resources individuals. We would like to thank our contributing authors and all of the individuals for our webinars and learning collaborative that are now available to anyone to use who shared their time, talent, and expertise with us throughout our Clinical Work- through our website www.chc1.com/nca. Thank you as well for your input and force Development National Cooperative Agreement (NCA) focused on implement- feedback throughout the development of this book, and for the contributions ing nurse practitioner postgraduate training in community health centers. We are you are making every day to the transformation of primary care. indebted to Anna Rogers, NCA Project Director and Reema Mistry, NCA Proj- ect Coordinator for keeping this book on track and moving forward through its Maria A. Alonso, MBA Shelby Lee Freed, FNP-BC many revisions. We also owe a debt of gratitude to all of the health centers across Rich Bettini, MPH, MA Pat McKenzie, MSN, WH-BC the country, the health center leaders and program directors who have taken on the work of developing NP residency and fellowship programs and to those new nurse Elizabeth Bezos, BS, BA Sara Mertz, MS, RN practitioners who have joined them out of their deep commitment to exemplary Mary Blankson, DNP, APRN, FNP-C Jonathan Muther, PhD practice as primary care providers in the nation’s health centers. We also want to acknowledge those organizations making a significant contribution to the field and Robert Block, CPA Rebecca Norwick, FNP, DNP(c) advancing the model of postgraduate residency training. A partial list includes: The Tom Bush, DNP, FNP-BC, FAANP Grace O’Shaughnessy, LMSW U.S. Department of Veteran’s Affairs, the Association of Post Graduate APRN Veena Channamsetty, MD Diana Paris, MSN, FNP-BC, RN Programs (APGAP), Advanced Practice Provider Executives (APPex) and the National Nurse Practitioner Residency and Fellowship Training Consortium Beverly Coleman, MA Candice S. Rettie, PhD (NNPRFTC). Sheryl Cosme, MSN, RN-BC, MSN Kathryn Rugen, PhD, FNP-BC, FAANP Finally, we want to acknowledge the leadership and support of the Community Patti Feeney, MS Mark Splaine, MD, MS Health Center, Inc., its Board of Directors and its leadership, particularly Mark Ann Marie Hart, PhD, FNP-BC Todd Wallenius, MD Masselli, President and CEO, for their early and ongoing support of the first formal nurse practitioner residency training program in 2007 and all that has followed from Erica Hastings, MIHMEP Deb Ward, RN that leap into the future. DoQuyen Huynh, DNP, FNP Dan Wilensky, MD Margaret Flinter, APRN, PhD, c-FNP, FAAN, FAANP Kerry Bamrick, MBA Contents INTRODUCTION ............................................................................................... 9 CHAPTER 1 Introduction to the Origins of the Movement for Postgraduate Training for New Nurse Practitioners ..........................................11 CHAPTER 2 What Does it Mean to Train to a High-Performance Model of Care? ....................................................................... 29 CHAPTER 3 Building the Case for Starting a Nurse Practitioner Residency Program ................................................................ 43 CHAPTER 4 Nurse Practitioner Residency Program Structure and Curriculum ....................................................................................... 59 CHAPTER 5 Clinical and Financial Resources ............................................................................ 91 CHAPTER 6 Operations and Administration ........................................................................... 109 CHAPTER 7 Evaluation: Real Impact Verified ..........................................................................131 CHAPTER 8 Accreditation: Anchoring Credibility and Trust ...............................................

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