title: Nurse practitioners as leaders in a quality health care delivery system.
abstract: Access to health care is often difficult for people infected with the human immunodeficiency virus (HIV). This article explores the role of the nurse practitioner (NP) within a self-directed, multidisciplinary framework, attending to the needs of a large population infected with HIV and acquired immunodeficiency syndrome (AIDS). The role of the NP is examined through the concepts of case management, primary care, multidisciplinary teams, consultation, and patient advocacy. A model is presented that describes the interaction between external stimuli and the central foci, with the NP being the orchestrator of the dynamic flow of communication. Positive consumer and professional outcomes will be identified as a result of the success of this model. It can serve as a framework for future health care delivery systems that provide cost-effective, accessible, continuous, quality health care.
authors.affiliation: Special Infectious Disease Program, Department of Veterans Affairs Medical Center, San Diego, California, USA.
authors.forename: G N
authors.initials: GN
authors.lastname: Pfeffer
authors.forename: J A
authors.initials: JA
authors.lastname: Schnack
mesh_terms: D003695:Delivery of Health Care / Q000458:organization & administration* / Q000592:standards*; D006801:Humans; D007857:Leadership; D009722:Nurse Practitioners / Q000458:organization & administration*; D011787:Quality of Health Care