As 2016 draws to a close and I finish evaluating my students’ progress in each of the DNP Essentials, I have been thinking about how to continue pushing myself also. For me, completing the DNP degree was a transformative experience. I started the DNP program with a goal of earning a doctorate so I could teach in a graduate program. I finished the DNP program with a vision of transforming healthcare, particularly for the under served.
I am currently working for two free clinics. One serves a mostly immigrant population from northern Africa, the Middle East, and Southeast Asia. The other is a bridge care program started by NPs at a local university with a goal of getting more underserved individuals into the healthcare system. In both of these clinics, we struggle with providing high-quality, patient-centered healthcare for people with no insurance and limited resources. Many of our patients do not speak English. This is a huge barrier when trying to navigate a healthcare system. Many have not had the opportunity to complete basic education and left school after 5th grade. Each of these clinics has a list of programs and resources to which we can refer them and through which help individuals apply for care. However, we need to break down silos and start truly working together for the benefit of the individual.
In the past week, I have attended two different local conferences. One was sponsored by the local health department to discuss local grant money available to non-profits serving county residents. The other was at the university that sponsors the bridge care program to discuss SBIRT implementation in our clinics, as well as with community partners. I should mention that the university has a SAMHSA grant for SBIRT. The discussion and connections developing as a result of each of these conferences has the potential to create new models of care that reduce barriers to care for the underserved.
Part of my graduate education, as I am sure is true for many of us, included learning about community oriented primary care (COPC). In my location, each of our three counties has completed a community assessment and set priorities for the next few years. Using this information as a starting point and with intentional dialogue and work groups from many different service providers and stakeholders (most importantly our community members) would help us create a COPC model to deliver high-quality, cost-effective healthcare and social services particularly to the most vulnerable in our communities.
As we all contemplate the potential dissolution of the ACA and how we will provide healthcare services in a changing political and reimbursement landscape, we need to consider new possibilities. What if we all started a discussion of COPC in our communities or built on existing models that work to improve coordination of healthcare and social services necessary to create a healthy community? We know that healthy communities are productive and economically stable. This will create less poverty, less crime, and more social connection in addition to healthier individuals and families.
How are you using the DNP Essentials to drive your practice and improve healthcare? I challenge each of you to revisit the DNP Essentials and consider how you can improve your practice or community using these as a guide. Where is the gap in care or care delivery that you can impact? DNP graduates have the knowledge, skills, and ability to change the world. What will you do?